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Pregnancy

Talk about every stage of pregnancy, from early symptoms to preparing for birth.

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Original poster

To HAVE or NOT to have an episiotomy??

17 replies

Leilababyno1 · 19/12/2010 22:38

Hi,

Recently, I have been thinking about a birth plan. The one thing which keeps coming up during my research, are conflicting ideas about the episiotomy

My main concern is that the cut made by an episiotomy would be more severe and take longer to heal than a minor tear? Do most first time mums tear? If so, to what degree? Is there anyone out there that regrets having an episiotomy? Is there anyone out there that wishes they had had an episiotomy?

Anyway, I think you get my point? Also, I don't know how many more times I can write episiotomy!

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Eliza70 · 19/12/2010 22:52

Think you can overthink these things to be honest. I honestly didn't give this a thought beforehand, I still (two children later) don't know what the stages if labour are or what crowning is. Although I understand that being informed and prepared is more important to others. For what it's worth I had an epsiotomy with DS1 - they needed to get the baby out, I wanted the baby out. Stitches yes, how many? No idea. Healed fine. No further complications. DS2 I tore, I have no idea to what degree or where. Stitches, or clips maybe? Healed fine, no further complications.

RockChick1984 · 19/12/2010 22:54

Hi, am really interested to hear what people have to say about this as well, I'm 27 weeks pg with my first baby so also debating what I want for my birth plan. I have read the same about a cut taking longer to heal than a tear, but obviously a cut can be controlled so would be better than a severe tear! Xxx

pooka · 19/12/2010 23:00

I said in my birth plan that I didn't want an episiotomy.

I tore, but not terribly badly. Had stitches but a prob with the stitches meant I had to have an episiotomy when dd was 7 months old, with a restitch.

With ds1 I didn't specifically request either way. Tore but while the tear was prob worse than first time, healed beautifully.

With ds2 I didn't tear, but had a small graze.

Thinking about it, don't think I would have done anything differently WRT the birth plan though I wish I'd not had an epidural first time round. I think I pushed so bloody efficiently and in the heat of the moment of birth I didn't really stop (was very numb from the epidural and had also had pethidine some time before) and was waiting for the midwife to tell me to pant. I can't remember what word she used but it wasn't pant and crossed wires and all....

With ds1 and ds2 I didn't have any pain relief apart from gas and air. I was much more aware of where I was at wrt delivery. Was expecting to tear again with ds1 because had previous scar from tear AND episiotomy.

I'd recommend going with the flow and seeing what happens.

Scouseem · 19/12/2010 23:05

I had one because my DS had his head turned to the side and was stuck and had cord round his neck and to be honest they done it for his safety so I would never say no to something they think is right.

My stitches did get infected but think that had more to do with fact I got told 4days later that you should have 2-3 baths a day to keep them clean.

MissAnthropy · 19/12/2010 23:08

I didn't want an episiotomy really. But I had one stuck baby and they needed to do one to try a ventouse and manual rotation.

There were a lot of things that I didn't want tbh but when it turned out that dd was unbirthable, I had to have the exact opposite delivery to my ideal.

It's fine to have a preference but keep an open mind as to what might happen. If it gets to the point where the baby needs to come NOW, really you won't care either way in that moment. But you do have to come to terms with it afterwards so accepting the possibility of it now might help with that iyswim.

OldieButBaddie · 19/12/2010 23:15

Surely you wOuld only have one if it was needed
And then you would

My birth plan page in my notes said

Have a baby

MumNWLondon · 19/12/2010 23:23

I tore (but not severe, 2nd degree) with DD (first baby) but it healed well and quickly and no tearing with DS1 or DS2. Had 2x baths a day with either tea tree oil or calendula. No ongoing probs at all, and all seemed to be back to normal by 6-8 weeks.

I would have prefered epis to CS...

SIL had epis and it got infected and took months to heal but she didn't have the 2 baths a day.

LittlePushka · 19/12/2010 23:23

Could I just let you know my experience as I think it is proof that you can overthink these things because I had two very different experiences. (BTW I had no birthplan at all save that I did not want DH to be there at the crucial point, so I did not have any point of view about it.)

First child with huge head became distressed after a lifetime of pushing. Dr Lovey calmly said at 9.20pm " pushka, this baby is in distress may I cut you to get your baby now? No brainer really but just seven minutes later I was done, baby born. No especiall pain with it (hell, its all relative at that stage anyway!) healed well and could not tell in anyway I had had it IYSWIM.

Second child came out like lightning. ISecind degree tear (unbeknown to me at the time,..though as I say , the pain is all relative!). Again stitches healed well still no adverse effects.

I think i am trying to say that with both of my experiences there was no "choice"...as MissAnthropy says.

Original poster

Leilababyno1 · 19/12/2010 23:23

Sometimes episiotomies are carried out without there being a urgent medical need for one. In these cases, the birthing mum does have a viable choice (which may be very difficult to make once painful labour is established). That's why I was curious to hear other women's opinions on the for/against.

OP posts:

MissAnthropy · 19/12/2010 23:27

You will always be asked to give consent and nothing should be carried out without your say so.

I just meant (kindly) that what happens on the day will be down to sheer luck. And if you approach it as knowing that you might 'need' a certain intervention and will deal with it when it arises, then you don't see any intervention as 'bad' or 'to be avoided'.

There's nothing wrong with saying I'd prefer xyz, but keep an open mind.

LittlePushka · 19/12/2010 23:37

What I meant was that for me personally the choice was Hobsons choice!

Laurtopsy · 20/12/2010 00:06

Episiotomies are no longer routine in my local hospital and are only performed when the doctor deems necessary. However, when the doctor deemed necessary didn't appeal to me unless there was a definite life or death fear so I put in my birth plan exactly that. No episiotomy unless there was a definite and severe risk to either myself or my baby without one.

With DD1 I had a second degree tear 'right round' and had to have 32 stitches. I had an hour and a half second stage (pushing) and she decided to come out with her hand near her head. It was horrible pain tearing but I didn't even think about it, it was over, I was stitched up and while it hurt a little for around a week I healed fine with no infection.

With DD2 she came out so fast everyone had thought I'd torn. I hadn't. She had a 38cm head and was 8lb 11oz and the nurses, midwives and doctor all acted like I'd performed some kind of miracle .

Tears usually heal better than episiotomy cuts. They are also (usually) less painful while healing and apparently less prone to infection.

Laurtopsy · 20/12/2010 00:12

I have to add that DD1 was born near her due date at 9lb 7.5oz with a 36cm head but nobody congratulated me on making magic then! Distressing.

wussbird · 20/12/2010 09:38

Oldie at your birth plan!

Think that's what I need to write this time.

Leila you won't care either way regarding cuts/tears when you're in the middle of labour. All you want is for the baby to get out! My advice is to do what the Drs etc think is best.

giraffeshatewinter · 20/12/2010 10:31

My birth plan says 'please discuss any interventions with me'. This means I get warned about what's going on, and know why they're doing something. I don't think I can decide whether I want to tear or be cut so far in advance - they have more medical and birth knowledge, and I trust they will do what's right at the time. Also don't want to spend time agonising over something that might (fingers crossed) never happen. Just want the baby out safely (and quickly and painlessly of course ).

FoxyRevenger · 20/12/2010 12:36

I had an episiotomy for a forceps delivery. I didn't feel anything because I had a strong spinal block in case the forceps didn't work and I needed a section.

It healed beautifully, no pain, no scarring, nothing. You'd never know it had happened.

I really wouldn't worry too much and overthink it. Whatever needs to be done, will be done, and you'll just be happy that you and your baby are safe.

midsmom · 20/12/2010 12:48

they will discuss everything thing with you before they do it anyway and you have forms to sign (even though i dont remember dsigning them as was too knackered)

They only do episiotomys in emergencies now so if you do have one you can be reassured you needed it.

There is no saying what type of birth you will have unfortunately i ended up with an emcs where the healing time is far longer. Like everyone else has said think its just better to keep an open mind.

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