Ezpiz, will it happen again?

Hi

I had a epiziotomy with DD and was wondering when i decide to have another baby, will i automatically need another one?? I rated the pain of the stiches far worse than the entire birth.

Just wondering if anyone knows???

I think there is a good chance that you may tear along the scar site as the scar tissue isn't as flexible. You can request that they avoid cutting you and help you to slow your pushing to allow the perineum to stretch and hopefully avoid the need for it.
I wasn't cut but I tore and have done so in the same spot for all three of my births. My last two were very fast and unfortunately there wasn't much we could do to prevent tearing.
You could try massaging the scar tissue to soften it in the latter stages of your PG.

Hi Jennifer,

I agree, you wont necessarily need an episiotomy. I had one with my second who was a VBAC and had a 2nd degree tear with my third. I found that the tear wasnt as painful as the episiotomy and it healed much quicker.

Good news, you won't necessarily need one. I had one with DS#1 after I started to tear. When DS#2 was nearly due I asked the ob whether I would tear again as I had that scar. She said not necessarily at all, as although the scar is there, the whole area is more strectchy next time, so it could go either way. As it turns out I did tear but only a very small amount which didn't need an episiotomy. The pain from the stitches this time was nothing compared to the first time, I didn't even come close to needing pain relief. I suspect it was bcos it was a smaller tear this time.

I wouldn't worry!!

Hi Jennifer,
The Pink Kit has some good suggestions on what they call "internal work" - it's like perineal massage plus plus. It helps you get familiar with your anatomy as well as conditioning the tissues. The idea is that you can feel what is happening when the baby is descending, and through practice, know when to really relax and breath out and let the baby through. My second baby was born very fast and I tore a little bit. Third baby I was determined to avoid that. So I consciously back-pedalled when I was close to crwoning. The midwife was yelling at me to push harder. But I was deliberately slowing down to avoid a tear. It worked. Another idea is that when you know you're just about there, there are two forces helping to bring the baby out: one is the expulsive force of the uterus. The other is your volitional pushing. If you have both forces at the same time, it can be a double whammy which can cause a tear. So sometimes they suggest you give a little volitional push in between contractions, so you have only one of those strong forces happening at a time.
At the last birth I attended, the midwife and I made heaps of warm compresses wih olive oil squirted on them, then applied to the perineum. I thought that was a nice touch!
You won't automatically need an episiotomy and if you want to work towards avoiding one, you can. I hope you can find a midwife who will support you in this goal. Hope all goes very well.

Hi Jenifer
I have never used performed an episiotomy and never will. When they cut they cut the skin and muscle around the vagina to increase the size of the opening. If you are lucky they may give you a local.

There are 2 main reasons that are given for the need to do Episiotomy.

1 The baby is stuck / The baby will get stuck
There has never been, nor will there ever be, a baby that gets stuck on the soft tissue around the vagina. Babies only get stuck by bones.

2 To prevent tearing.
Cutting will not always prevent tearing, in fat it is not unusual for the tear to extend. Also If they cut then you will have a wound, however if they do not cut then there is a chance that you will not tear and hence no wound.

Finally some research suggests that an episiotomy wound takes longer to heal than a wound caused by tearing.
Because you already have a wound there then the chances of you tearing are higher. As others have said the scar tissue is less elastic and will not stretch.

To help reduce the chances of tearing there are a few tricks you can try.
Perineal massage- For a few weeks before the birth, at least a couple of time a day insert a couple of fingers into your vagina and stretch it until you feel a burning sensation and hold it there for a minute or so. In theory this I supposed to make the tissue around your vagina more elastic.

Birth position- Do not give birth on your back. This position is known to increase your chance of tearing.

When the baby’ head is crowning try to slow down the birth by not pushing too hard, this will give more time for stretching.

There are a number of devices for sale that are also supposed to help prevent tearing. You could get more info about these on the internet.

If you need any more info just let me know. I would be happy to help