Episiotomy

[Tweetyeyes]

I am 6 weeks postpartum and had a traumatic birth, baby was in distress on arrival at hospital 9cm dilated. Midwife pushed cervix out of the way and I was told to push and bullied into giving permission for an episiotomy and suction cup/forceps. I delivered with just episiotomy within 35 minutes of arrival at hospital.

I am really upset about the episiotomy, initially I thought recovery was going so well and much easier than my tear on my first baby (internal and labia tear not perineum). However I have now looked this week and I feel mutilated - the skin at the base of my vagina is gone (where and how?) and it all looks horrific, big scar and clumsy stitching evidence (stitches now dissolved). It doesn't help I also have an external haemorrhoid. I have felt inside my vagina with a finger and my cervix is to one side half way down my vagina (it was central and at the top). I don't think I will ever have sex again and I am incredibly distressed at my body. I am also leaking urine if I don't go to the toilet immediately when I feel the urge to pee. I'm in a lot of pain but this is haemorrhoid / anal fissure related and not episiotomy. I am grieving the third baby I wanted and snapping and angry at my husband who asked when we could "fuck" in a jovial way this week.

Anyone else horrified by episiotomy? How long has it been and how do you feel now? Did you ever have sex again? Is my cervix prolapsed? How do I even begin to say any of this to a GP? I know full well they will suggest pelvic floor exercises and antidepressants if I tell them and I honestly will struggle not to tell them to f*ck off.

You say that your baby was in distress on arrival at the hospital, so they needed to get it out ASAP. That’s why they did the episiotomy. Think about what could have happened.
Are you doing daily pelvic floor exercises, and have you asked to be referred to the women’s physio?

Do you still get checked out at 8 weeks postpartum, if so I would definitely mention your concerns then. I had an hours worth of stitching after my first DC was born, I can honesty say I’ve never felt around or looked there, but I know I lost feeling there and sex for me was never the same, although we did have healthy sex. I did put off my 8 week check for 2 weeks as there was no way I could have had an internal examination. I did get the chance to go through the whole birth in detail with my Health Visitor, who basically said I was 5 minutes away from emergency c section, as both baby and me weren’t doing well, so that helped me, as I think this caused me to have more than just baby blues. PS I did ask my DH if all was ok down there after, all he said was everything was more loose, which I expected, so lots of pelvic exercises which helped.

I had an episiotomy both times. First was an emergency ventouse, second an emergency forceps.
at 6 weeks it was still carnage. It takes time to heal. I remember with my second it was nearly 6 months.

i self referred to a gynea physio who was helpful, but mainly it was letting my body heal.

Oh OP, I sympathise but I feel like it’s still very early. My episiotomy was pretty big and it took a long time to properly heal, a horrible painful infection didn’t help either! But now you can’t really tell, the scar has finally healed really well. You’ll get there, it’s still very early days.

Find out how to get access to specialist pelvic physio.
In some areas you can self refer, in others you need to go via GP.

While yes, the answer is often pelvic floor exercises there’s a lot more to them than just doing squeezes (particularly as you may not be doing them with the best technique).

Things do take time to heal, I look nothing like I did a few weeks after birth (after a difficult forceps delivery, episiotomy and tear). While you sort out physio, keep doing the exercises - they encourage blood flow and that’s good for healing. And that works regardless of how good or otherwise your technique is.

I had an episiotomy which also tore. It took a really long time for everything to heal. That said, the urine leaking is something you should get checked out asap, ring your gp as you could have nerve damage. You can also ask for a review of your birth with a midwife, it sounds like it was a really scary situation and quite traumatic for you. Give yourself time to recover.

Have you had an episiotomy?

I had an emergency episiotomy and forceps and struggled for a long time with urinary issues PP. It felt quite bleak for a while. I endured a frankly humiliating 8 weeks check up with a (female) GP who was too rushed to GAF but did make the referral I needed to specialist physio. When I eventually got past the waiting list the sessions with the physio were invaluable. It's been a very gradual recovery but I am now back to running again which I never through possible.

Thanks for the kind responses. Still feeling shit and like half my vagina is missing. Will try to articulate myself next week without crying at pp check x

They did an episiotomy on me without permission. I was adamant I would not want that. They say I consented but I fucking didn’t birth partner confirmed this.

i was sewn up wonky. At my 6 week check I raised this and was told it’s actually not that bad many women have it much worse. It was so wonky I had a sort of extra hole/indent thing. Told if I want more kids then I just have to live with it- even though I was in pain from it every day and conceiving a new child would be a horrible experience l. Was painful to have sex for over a year. I had another baby who stretched it all out and I tore where my extra hole was. They stitched it better this time and I’ve had no pain from the episiotomy since.

the way women with birth injuries are treated is disgusting

First, congrats on your baby. I had an episiotomy with my ds and then when I had my dd it tore and had to be restitched. The first time, the midwife did a crap job at stitching and I was in a lot of pain and it never felt right. I had to have the stitches cut as it had been done too tightly. Even a few years later, it would ache if i stood for too long or during sex. When I had my DD it tore right along the scar tissue. This midwife sewed it beautifully, it healed quickly and I’ve not had any issues since.

When you have your newborn check up at 8 weeks ask them to look. If they won’t, book a separate appointment. It may need restitching or it might just need cream. It’s still early days, it will take a while to heal. In terms of your cervix, it could just be it has changed position due to all the hormones surging around your body at the minute. Try not to keep checking, you’ll send yourself crazy.

Keep on practising your pelvic floor exercises and see your gp. Best of luck OP.

You need pelvic floor physio early. Demand to be seen to and if your facing any wait lists get a private session or 2. Im so sorry you've had such a tough birth.

I had an episiotomy with a ventouse delivery. I must admit I never looked till about 8-9 weeks on advice from my mum who had the same haha! I’d discuss concerns with your GP or at your 6 weeks check if you’ve not had it yet. I would definitely mention the leaking urine.

It doesn’t matter if you cry.

And if you’re concerned about whether you’ll manage to articulate it in the moment, write it down on a piece of paper.

Then when you get the ‘how are you getting on’ question at the start you can say.

Not great, but I struggle to talk about it so I’ve written it down. And hand them the piece of paper.

Thanks. I find I've a history of depression been treated on medication 3 times for a year period in last 15 years and if I cry I just get told to take antidepressants and the health issue I'm upset about is ignored.

I had an episiotomy with emergency forceps for my DS who is now 15 months. I took a lot longer to heal than my mum friends who had tearing (yes we spoke about everything!) . It was nearly 3 months until I would say it was normal and longer until we had sex again. It’s a very slow process so give it time but I saw a GP or midwife 3 times to check on the scar and healing. Over a year on and it’s now a very large but painless white scar.

We conceived our second before Christmas which very sadly ended in miscarriage but shows we were able to have sex and conceive again. I am now going through healing and cervix returning to normal position after the miscarriage. I have felt very supportive through both the birth and miscarriage but keep pushing for referrals to specialists or further help. It’s such a shame it’s a lottery as to where you live as to how much support is offered.

Congratulations on your wonderful new baby and give it time.

sounds rubbish, please do go and see your GP and cry if you need to.

My pelvic floor will never be as it was and I was in tears about my episiotomy for weeks, but a lot did resolve itself. And there wil be help available for the bits that dont.

I do feel that as women we are not properly warned about how common it is it to need an episiotomy and how horrendous the recovery can be.

I had a very big emergency episiotomy in November. It was scary and awful. The midwife stitched it well but it took a long time to heal. I felt physically brutalised and drained from being in pain constantly, and was very emotional whenever I spoke about it. It took about 8 weeks for my body to feel like my own again, and 10 to resume running. It wasn't until 14 weeks that I could see myself starting to come back, and baby and I really started getting into the swing of things. DP and I still haven't had sex and am only just starting to feel ready to think about that; thankfully DP was also traumatised and is supportive happy to wait for me, and I know I'm very lucky in that regard. I know 6 weeks feels like a long time when you're also caring for baby 24/7 and seeing them grow and change but it's really quite early in your healing journey, both physically and emotionally, from a traumatic birth.

However, the urinary leakage is not normal and you need to see a women's physio urgently. I imagine if your pelvic floor was moved aside forcefully it may have contributed to this.

As for your husband, tell him when be has his penis sliced open and sewn back together again he can have an opinion about it but until then to keep it to himself.

And finally, when you do feel emotionally ready, you may wish to think about requesting a birth debrief from the hospital to help understand and discuss what happened.

Sending love and happy to be PMd, I know too well that those first few weeks are really rubbish.

I really feel for you.

Similar to another poster, my first was episiotomy and ventouse - I felt 'sliced and diced' but at the time was told it was that or risk my child's life. I found out later it was more about them going for break than real urgency for delivery.

The midwife seeing me afterwards said the stitches had been done too tight and had to release them - the pain had been incredible and I had struggled to sit at all (even with doughnut cushion and painkillers) .

It took a long time to heal - I laugh at the memory of being told to 'keep things clean' as my only wound care advice.

Please take it easy, spend lots of time resting and eat well. Your DH can assist you in this. Talk to your GP about how you are feeling although in my experience post natal wound care is not their forte but they might be able to refer you to someone who can help.

I really hate how women's birth injuries are seen as totally unimportant - after all 'you've got a healthy baby, what are you crying about' - seemed to be the attitude.

It took 9 years (and an accident) for mine to heal. The doctor cut me incorrectly.

DD is an only because I couldn’t climb stairs without pain never mind have sex!

This is horrific. Sending a hug x

I had forceps delivery with epsiotomy. Took about a year to feel "normal" down there. But alternative was not an option.I contacted PALS and got sent a photo copy of my pregnancy and labour notes as well as ward notes. Maybe that will help you too a little.

The birthing team wouldn't have cut you for no reason. You said yourself that the baby was in distress.

I had an episiotomy and 2 other second degree tears. Healing was very hard and I had to really focus on pain management. But I had them because my baby was in distress and he needed to be born very quickly.

I had an episiotomy and forceps due to foetal distress. I was 25 and welcomed a beautiful baby girl. That was 37 years ago and when my daughter had her first baby I was really worried she would go through the same or even worse a 3rd degree tear. I was doubly incontinent for 2 weeks and frankly the pain was awful. I chose an elective csection for next child. It's horrible but truly you will heal and it was done in the best interests of your baby. Do your pelvic exercises and give yourself time. Sort out your other issue and look forward to being intimate with DP again. He won't mind and invest in some lovely knickers!

I had forceps, an episiotomy, missed third degree tear and missed tear in the other side of the vagina. I was given forceps and an espisiotomy for no real reason, my baby wasn’t distressed, I think they just wanted the bed freed up as my labour had been long. I’m around a year post partum, my life has been ruined. It’s never healed and I definitely won’t be having sex again (it’s actually not the biggest thing I’ve lost over this, but sad to think about it)! Sorry to be negative, as you just had an episiotomy it might improve for you. Ask for vaginal estrogen cream as that can help some women.