episiotomy question

[Libby1985]

hi. I was just wondering if getting an episiotomy hurt if you were having a drugfree labour?? i had one with DD but i also had an epidural so i was off in laa-laa land and didnt feel anything. Do they cut you when ur contracting or when ur between contractions??
also ive heard that tearing hurts less than an episiotomy during healing. is that true?? would you be better off tearing or having the doctor cut you to stop possible tearing??

[*EmJa*]

i had an epidural but didnt completly work and i felt it when they did the episiotomy and i screamed (was the only time i screamed through my whole labour!) it pretty much felt like wat it is a knife cutting you:/ i think they cut me during a contraction and when i was pushing, cos my babies shoulders were stuck..ive heard that its better to get a episiotomy than tearing cos yeah it heals quicker and hurts less.

[mrmoo]

My last birthing was a drug-free vbac and I delivered a 10lb 4oz baby with no tears, no cuts and only 2 slight internal grazes = no stitches. I didn't do any perinium stretches prior to labour. I did listen to the midwife when she said during 2nd stage... "stop pushing and let the baby stretch you, I'll let you know when you can push."

[SSmiles]

Hi! My episiotomy definitely hurt!! Real bad!!! I didn't have any drugs (not by choice) and I felt everything... I honestly don't remember if they cut during a contraction or between contractions...basically the doctor walked in after about 3 hours of pushing took one look and asked for the 'scissors' (or whatever they're called) and cut me before the end of that same minute.

My healing has been a long road...it was extremely painful for ages afterwards and I still get some pain 'down there'...not sure if it's from the episiotomy or what though!?!?

[DoulaRelle]

I tore with DS 1 during a forcep delivery with an Epidural that didn't work, and I was cut with DS 2 during a relatively drug free labour(gas only)

I found the tear alot more difficult to recover from, but that could also have been the bruising from the forceps.

When I was cut the 2nd time, I did not feel a thing, they ususally give you a local to numb the area before cutting you though, unless I guess it was a real emergency and they didn't have time.

For me the Epi was easier to recover from, but then I guess it also depends on the degree of tear you suffer and then the recovery from that.

[Janie]

I have heard/read that you might be given LA when they are performing an episiotomy, or if the perineum is stretched very tight the skin will be numb anyway (LA should be given for stitching though? Obviously this is if you haven't had an epi).

An episiotomy will apparently often take longer to heal than a tear, and can be more uncomfortable.

I have no idea if this is true though, it's just info I've picked up along the way

[Lea13]

I am pretty sure that natural tears heal alot quicker and easier then episiotomy. I've never had one but from what I've heard in comparison in to my experience with tearing that seems to be the case.

I was adamant I wasn't having a episiotomy and the midwife just kept threatening it. I got him out fine and had a small tear which required 4 stitches - there would have been more if she had cut.

Most midwifes have never performed an episiotomy because there generally never is a real need.

Because you've already had one it is likely that you will tear along the scar line anyway.

[Ellibam]

i had both when i had makon. i dont remember any pain when the doc cut me but i vividly remember tearing! the epi took longer to heal and hurt more after then the tear!

my mum (whose a midwife) said its better to tear as tou tear at the weakest point so when healing its not a thick chunk of skin with many layers! where as with an epi they cut you near the back part which is usually thicker!

[Snacks]

I had a drug-free labour and a 2nd degree tear. Didn't feel the tear and had LA for the stitches. I've healed up no worries. I was really afraid of episiotomy/tearing, but as I said, I didn't feel it at the time. I personally wouldn't want an episiotomy, unless the midwife believed I would be torn to shreds otherwise.

[Olive]

i had an episiotomy , they cut with the contraction, i will never forgt seeing the midwife standing there watching me waiting to cut!! only slightly felt it as sez said it was stretched and quite numb. the la to stitch up hurt more and the recovery was awlful!!! couldnt walk properly for about 10 days couldnt sit, i healed too tight and now have to stretch the area!!

[krysalyss]

At our antenatal classes the midwife (who seemed to be very into natural births and interception only when absolutely necessary) said if they think you will tear a lot they will do an episiotomy because the danger is if you tear from your vagina down to your anus you can be in a lot of trouble. When they cut, they cut off the the side to prevent this. She also mentioned the importance of a slower birth (eg. stop pushing when they say to stop pushing!) in preventing tears or cuts.

[Percy]

I had a drug-free labour and a 2nd degree tear. Didn't feel the tear and had LA for the stitches. I've healed up no worries. I was really afraid of episiotomy/tearing, but as I said, I didn't feel it at the time. I personally wouldn't want an episiotomy, unless the midwife believed I would be torn to shreds otherwise.

ditto ditto! I had a drug free birth and had second degree tears as well. Personally for me the injection of the local anesthetic they used to stich me up was way more painful then the birth. I didn't even know I had torn until my midwife told me so. I also healed quite quickly from it - I was walking around quite normally within a day or so. Now nearly four weeks later I am back to 100% normal. (actually I was back to 100% normal within 2 weeks!)

[castle]

Midwives have told me that a natural tear is usually better. If you tear, it might be only through skin. An episiotomy is ALWAYS through muscle. Exceptions when an episiotomy would be better, are if it looked like you were going to tear badly---if you felt like you couldn't control the pushing at all--or if the baby is in distress & needs forceps or vacuum.
For me, avoiding an episiotomy was my no 1 concern in giving birth!! With DS no 2, the pushing stage lasted a very long time, so i was completely numb from pressure & stayed numb for hours afterward. No episiotomy, even though he delivered face up. If I had needed one, I would not have felt it anyway! I had a tiny tear, which felt like a paper cut for a day or two. It wasn't gaping so it wasn't stitched.
With DS no 3, pushing was much shorter & I had no numbness after delivery.No episiotomy or tears. With both, I did listen carefully to the midwife as far as when to push, when to blow. The other births were c/secs.
You can ask at the hospital about their episiotomy rate. One midwife said to me, "You won't have a vaginal caesarean here but you have to understand that if the baby is in distress & needs to come out quickly, you won't have any choice about the episiotomy." That made a lot of sense to me.

[chocolatecatty]

I had a drug-free labour and only had a tiny tear which required no stitching.
From what I've read, you're better off tearing, as Castle says, an episiotomy is always through muscle and will be a minimum second degree, whereas tearing is along muscle and heals quicker and can only be minimal.
Hehe, the midwife was going to cut me and had the needle primed to inject me but I had one last contraction and pushed Caty out. Thank goodness, the midwife had never done one before (which I guess is a good thing) so that had me a bit worried!

[AnyDream]

I guess I just wanted to add that not all tears are mild, in my case there was no midwife instructing me to breathe and just let the baby crown, it was a case of push harder we have to get this baby out NOW! No episiotomy, 2nd degree tears into deep muscle(multiple) and yes it was still affecting my sex life a year later (painful scar site). So I guess it probably depends on the circumstance that you find yourself in, I wonder if I might not have healed better with a single cut rather than a three way tear.

[Trillian]

I found that the epi I had with #1 took a lot longer to heal and was way more uncomfortable than tearing with #2 and #3 because the cut was made off to the side, so everytime I sat or lifted my leg it pulled and felt tight and uncomfortable for ages. I suppose the school of thought will differ on this one, depending on the circumstances as to which one you needed and how bad it was for you. With a tear the edges can be a little messy and hard to stitch up - I have a small skin tag left after having #3 which I will have removed eventually. repairing a cut is much neater, but it is also deeper.

[mrsmac]

I had a LA before the epi with #1(and forceps) it was a very big cut and required stitches inside and out (looking back now maybe I tore as well?) The doctor cut badly inwards towards the back and my OB commented unfavourably on the scar while I was having Riley last year (nearly 15 years afterwards!) I went on to have 2 more babies with no tears or epis so it must have healed well at least.

[Trillian]

Oh, I forgot to add that I had a LA with the epi but could still feel the cutting sensation but not the pain. When tearing it just felt really hot and burny down there at the time I imagined it to have happened.