childbirth after episiotomy

[glasspaw]

Hi everyone. I’m wondering if anyone can share any experiences that might help me know what I need to prepare for? 😂

my first son was born very quickly in hospital and I needed an episiotomy because his neck was in an awkward position in the birth canal. I recovered well from it but would really like to consider a birth centre for my second birth (currently in trimester 2). The problem is, the birth centre is about 30 mins from the nearest maternity hospital.

is it pretty much inevitable that I’ll tear or need another episiotomy if I had it first time? I know the midwife led units can do them but I don’t know whether they’re equipped to deal with the kind of emergency situation we faced last time.

I had an episiotomy with dc 1. He was 4 weeks early, my waters had broken at 34 weeks, he was 6lb 2oz, labour was around 6 hours. Ds2, born 21 months later, I had a vaginal birth with no intervention at all. He was days over due and nearly 10 lb, I didn't need a single stitch. I was in labour for 2 and a half hours. They were such different experiences. No 2 births are the same. Hopefully you can go to the birth centre if that's what you want. Good luck.

Episiotomy with first birth, took a long time to heal and was miserable for weeks. No tear and no stitches needed for second birth despite fact that baby was in an awkward position as she had her hand over her head as she was born and had obviously been wedged that way for a while as her ear was folded up for a few days after birth. I put the easy birth down to being at home (planned home birth) and I was more relaxed and in the classic and anatomically very useful upright forward open position on my knees and leaning forward. Also had a very good midwife who helped slow the pushing stage despite DD coming out at speed like superman 😂

That’s really reassuring, thanks both! I do think the environment and situation panicked me a bit so me being so tense probably didn’t help. Definitely hoping to feel more in control this time.

@Tiredmum100 my son was 4 weeks early too. Went into labour suddenly at 36 weeks exactly. Straight into regular contractions then had to be taken in by ambulance. I definitely want this little one to stay in for a bit longer!

Episiotomy for first birth has DS had a large head. Second birth no tears at all but DD did have a much smaller head.

I had a zero intervention, no tear home birth after being cut + stitched for ventouse DD1!

I had an episiotomy with DC1 and stitches. DC2 was born at home, I elected to tear naturally and refused stitches and recovered far quicker. In fact I don't really remember the tear but still remember the episiotomy recovery.

I had an episiotomy with DS1 (his head was at a weird angle and I needed forceps). Throughout my whole pregnancy I was terrified of tearing the scar, it became quite an obsession. However DS2's birth was about as near perfect as it could be. I gave birth in our lovely local birth centre in water and it was great. I did have a small tear second time around (in a different place) but was so relaxed it wasn't a big deal.
My first birth was not what I wanted as I had to go to labour ward due to gestational diabetes, 2nd was a world away. So much more relaxed and a completely different experience. I would recommend a birth centre.

I had an episiotomy and forceps with DS1 - three and half years later with DS2, who was half a pound heavier, no interventions!

Tearing doesn't necessarily mean you need hospital. I had a second degree tear during my home birth and it was stitched up on my sofa 🤣

I had a 3rd degree tear with my 1st. Gave birth to two more babies since with no interventions.

Episiotomy and forceps with my first, unassisted and no tears with second and third.

I had an episiotomy with DD1. Normal birth with no pain relief at all with DD2 but I did get a second degree tear (which was nowhere near as uncomfortable as the episiotomy). You are at slightly higher risk of tearing with a previous episiotomy but chances are that if you do, it'll be a simple tear. It'll all depend on the position of baby as they come out and the speed of delivery (mine was very fast which contributed to the tear). You can get stitches anywhere if you need them though, so I don't think that's a reason to choose hospital over anywhere else. Good luck!!

It’s certainly not a given that you will tear or need another episiotomy but it will depend partly on the location of the previous episiotomy and the nature of your recovery. I had a very long complex recovery as my stitches fell out due to infection and I was left with a lot of scar tissue, which does not stretch like normal perineal tissue. Many women are lucky enough to be left with little or no scarring.

Perineal massage and / or use of an ani-ball can help.

Hi there I am a registered midwife working on the labour ward. If you labour quickly why wouldn't you consider a home birth? Providing your pregnancy and labour stay low-risk, giving birth to a 2nd, 3rd and 4th baby is just as safe for mum and baby at home or in a midwife-led centre as it is in a traditional doctor-led labour ward (the risks slightly higher for 1st babies). Midwives and doctors train together every year on all sorts of emergencies. Episiotomy is a really minor thing as far as midwive's skills are concerned. If you develop complications you will be transferred to the labour ward anyway, midwifery-led unit are for low-risk women only

I had an episiotomy with ds1, @glasspaw, and went on to have two more babies (home births) with tiny tears each time - more like grazes, that didn’t need any stitching and healed very quickly and easily.

I also had an episiotomy for my first an tiny grazes for the second. The birth center I went to for my second was attached to the maternity ward though.

Episiotomy first time, nothing second time, similar size babies x

I had an episiotomy second time too but I had a second ventouse birth. So it was probably more because of the ventouse. The doctor who did my delivery said she thought I may get away without needing one even with the instrument given it was my second birth but sadly when it came down to it she felt it was necessary.

However statistically you have much better odds of not needing one second time around.

My old episiotomy tore during my 2nd birth. Was at home. The midwife just stitched it back up. They did warn me to slow down as baby was crowning but I just wanted it over and done with!

I had one (and a second degree tear!) With my first, my second I had the tiniest internal graze that took about 3 stitches that I barely even knew I had. She came very quickly, and was bigger than the eldest too so there was every opportunity for another tear but had absolutely no issues in that department 🙂

I had an episiotomy for DS1 (forceps as came out back to back due to a short umbilical cord). Came close to a crash section so delighted they hauled him out with no other damage to either of us!

DS2 was much easier but the midwife did cut my episiotomy back open because he was struggling and she said it would be better than having two scarred areas.

I was lucky and healed quickly both times.

18-hour labour (with epidural) needing an episiotomy with my first, and the stitches burst on day 3 which was agonising. I needed 18 x 1-hour sessions with a postnatal physio to fully heal and be able to run and jump again.

4-hour labour (with epidural) and the easiest birth ever with my second. A tiny tear which required a tiny stitch and I didn’t even feel it. The standard 9-sessions with the physio, and I was comfortably running 10 weeks post partum.

I was nervous too OP, but it was so much better the second time around.

Thanks all for sharing your stories. I’m so glad I posted this because I feel really reassured having read them!

@Tiredbehyondbelief i did discuss this with my midwife but we live in a terrace and honestly, I was not quiet enough to consider a home birth 😂 my neighbours would hate me for the decision. The birth centre is less than a km from me though and I recognise the signs a lot more confidently now so am happier that I can get there in time. I did go to hospital early with my first but what I was feeling wasn’t showing on the monitor and I was sent home despite being adamant that I was contracting regularly.

now that I know I was right, I can self advocate way more second time around :)

Episiotomy and venteuse for me first time round. Long labour on labour ward, felt very traumatic. Second labour took 3 hours in total, have birth in birth centre and had a second degree tear which was easily sewn up. The stitches healed much more quickly than first time round.

I also felt really worried about this and it all worked out ok. Good luck with your labour!