Episiotomy

Sorry if this is not where this belongs but I cant find anywhere else to post it.
I am beginning to think about my birth plan and whether to have an episiotomy or not. My mum told me that she had one and thought it was so much better than tearing. Yet when I researched it on google a lot of people said that they were in so much pain afterwards and others said it was better than tearing. Then I came across something that stated that if you do have one than there is more risk that you could tear further from the cut then you would not having an episiotomy at all.
Does anyone have any comments or stories as I still cant make up my mind.:help:

I was told your better off with an episiotomy then a tear.....i had a tear but it was unavoidable at the time. Mine healed with in 2 weeks... and i had no problems at all.

My sister had an E and hers took ages to heal and now has problems after 10 years of having her first one.....

The jury is still out on which is better. Some say tear as it is a natural wound, others say epi. The thing with having an episiotomy is that they are guessing where and how far you will tear to try to prevent that, the other thing is they can cut angled away fromn the anus to avoid the nasty all the way through tear. The thing with this is how do you know you are even going to tear? You may be causing a wound that isn't even necessary. I didn't tear my perineum (slight graze on labia which was no big deal), if they had done an episiotomy I would have had a harder recovery time. Episiotomies do have their place, but if it's not really necessary why cut there? Just my opinion.

I agree with Rachel that they do have their place - births that require instruments (forceps and vacuums) need the room the get the gear in there, so quite often a cut is made to get them in. Also if you look like you are going to tear badly or in the wrong spot, it can be better than letting you tear naturally. An Epi also cuts throught the muscle, which is why they take longer to heal and feel quite sore afterwards.

One school of thought is that when you tear, you only tear as much as you need to get the baby out and with an epi you may be cut more than you needed to be.

Having good birth management helps immensely, with the birth of the baby not being rushed and letting the baby take it's own time to be born and hence not creating a strain on the perineum as the area has time to stretch to accommodate the baby coming out.

I think that most hospitals don't rountinely do them as a matter of course, but use their judgement at the time to see if one is required.

I personally think that it is better to tear, the healing time was much faster and less uncomfortable.

I was told that generally an episiotomy is bigger than the tear would have been, and it tends to take longer to heal. but then, I think you'd really need to talk to someone who has had both to get a good idea. My mum had an episiotomy and couldnt sit down for weeks.

Personally, i tore, just 3 small tears not a huge one. I think they wanted to do an episiotomy but then didnt. I dont like the idea of an episiotomy, and I agree with Rachel actually... i woldnt ask for an episiotomy because it might not even be required. I think i would let the midwife/doctor make the call, or at least tell you what they think because theyll be watching whats going on and can probably see if you are likely to tear or not. having said that you might not be in the frame of mind to really think about it at the time either lol.

I had Vac extration....but didnt require an epi.....so there are ways round it..

However in my birth plan i did say cut me rather then tear...

I also had a vac extraction but no episiotomy.
I did tear but it was fairly minor and healed quickly. I'd take the tear anyday after seeing the hell my friend had after an episiotomy....took her forever to heal and she still has pain to this day :(

Hi there,

I got an episiotomy for my first and it was a shocker, but then that was NZ and they must have had a newbie doing it as I never quite healed properly. I think if I had of had a more active birth I could have avoided it but as we know first time around it is a bit of a shock and you are guided by your support people and my midwife was sort of useless. Anyway with my second (which I had in Melbourne) I asked not to have an episiotomy if possible but they did not believe my scar tissue was going to stretch enough so cut me again. I stressed that it was a terrible repair job so they tried to neaten it up but in the end I think it took me longer to heal second time around than first. I couldn't even pee it hurt that bad but these things happen.
I have two beautiful children and very little discomfort now so I am happy. Just wondering how to handle this area when we go for #3. Next time I am definitely going to write down and express clearly that I would like to try all possible ways to avoid being cut before they cut me again. But in the end if it is needed so be it.

Just be clear about what you want and don't let anyone push you into something without explaining the facts first (easier said than done when you are in labour but at least then they might think twice before just rushing into do something you might not neccesarily want) Just my opinion anyway.

Good luck in making your decision,
Heidi

I had an epi with DD1 but not by choice, they needed to get her out because her HR dropped which at the time i didnt know it does anyway when coming out the birth canal. I think the ob just wanted to go back to his dinner date.
I just had slight grazing with DS2 so it didnt interfer with following labours. I did find it quiet painful and it took a while to heal, but daily salt baths eased the pain alot so id suggest that if you need one.
With DS the midwife mentioned its better to tear naturaly rather than get cut because the tear would heal more normally, the skin goes back together like a jigsaw iykwim where as with sutures your skin is put not necessarily in the same position. If that makes sense.
I would never opt to be cut, but thats just me. Ive already had it and wish i could go back and do it again to say no way mate.

Thanks everyone. I think I am now leaning more to going natural and not having an episiotomy unless I am in great need of one they just sound to painful and the healing process seems longer. Thankyou.

I'm also leaning well and truely more over to the tear side of things due to my mothers awful episiotomy experiece (still torubles 30 years on) and also becaus I know someone who had an episiotomy AND still had a 4th degree tear. An episiotomy might be easier to stitch up for the nurse, but I'd rather take my chances with a smaller tear I think!

I can't quite remember where I read this, but somebody was likening the episiotomy situation to a piece of fabric. Your perineum is like a piece of fabric. It's not that easy to tear it. But if you make a tiny little cut into it, it will rip very easily. That analogy makes a lot of sense to me.
Also a natural tear is usually jagged so it creates a lot mor surface area for the wound to heal again. And natural tears usually occur along blood vessels rather than through them.

I'd definitely opt for a natural tear rather than an episiotomy. But I'm sure that there are cases where it would look like a natural tear could be more destructive than an episiotomy. I know my midwife doesn't like doing unneccesary episiotomies, so I trust her to make that decision.