Calling STMs.... Tell us about episiotomy?

[daydreamernyc]

anyone else starting to feel like this is about to become real?  I'm scared of what will happen during the birth. Will I need an episiotomy?  

For STM+,  did you have one? If so, why?  Baby too big or was the baby stuck?  Any long term effects/complications or did everything return to "normal"?  

I'm a bit nervous and just want to understand the truth. 

[silv3rlining]

My understanding is its not normal practice anymore like it used to be. I did not have an episiotomy nor did I tear. My OB was really good about luring it up/stretching (perineal massage). She did have to make a small snip of something (but it was internal I believe? My doula looked before she did it and agreed it should be done)

My guess is similar to tearing, once you're healed from stitches you should be fine.

[PurpleIris]

I don't think it's common practice, I've read that tears actually heal more easily.

My son was 9.5lbs with a big head and shoulders, I had a few small tears (one stitch each) and a bigger one that needed a couple of stitches but it wasn't too bad. I mean, as these things go it wasn't too bad, it still sucked a bit for a few days.

[daydreamernyc]

I'm glad to hear that you are all saying it has fallen out of favor. I googled it and saw a stat of 30-35% of vaginal births and that is a scary stat. I also read that it's better to tear than proactively cut. Would be interested in hearing from others.

[mathistm]

It is not common practice at all for the hospital I am delivering at. The reasoning I was given was they would rather you tear naturally where you are already stretched thin than possibly cut healthy intact tissue. My ob states that recovery is easier when you tear naturally.

[bendherova]

My understanding was that tearing naturally was "better" for you healing wise than episiotomy. I tore with DS1-- he was vacuum extracted and sunny side up. (face up, typically babies are face down).

We were taking walks in our neighborhood within the week. Everything was good by my 6w check up.

[pghtruelove]

I had one with my first, 11 years ago. They did mine as a precaution since I was 13 and not fully "matured". I had no clue what it was and when they explained it to me I was pretty devastated. My Dr did a great job, I already had an epidural(which I also had a very pleasant experience with) so all I couldn't feel the pain. He did a great job with my stitches which healed well.

My only bad experience was after I went home, I found that part of my placenta/umbilical cord did not come out of me(I really can't remember a lot of the details of that part because it was so long ago and I blocked a lot out) and I had to go have a vaginal ultrasound to make sure everything was out. It was awful to have that fucking wand in me with those stitches. I'm sitting here holding back tears remembering that.

[billyhorrible]

I didn't but I also barely tore. Pretty much as soon as I hit 9.5 cm the nurse started with perineal massage and continued it basically until the last "push."

[daydreamernyc]

billyhorrible, how big was your baby? That's amazing that you didn't tear!

[daydreamernyc]

pghtruelove, that sounds like a lot to go through at such a young age. So sorry that you had to go through that, sounds horrifying and painful. But glad to hear that everything healed

[ajm11]

I had one with DD a little over 2.5 years ago. She has a large head. After pushing for over two hours, I still couldn't get her out. She just got stuck. My OB did an episiotomy which tore to a third degree tear. I will be honest, the recovery sucked and I was sitting on a donut for at least six weeks. But honestly, everything worked out in the end and I healed great. Things didn't feel quite right for months, but I did make a complete recovery.

I am hoping this one comes out a little easier.

[billyhorrible]

daydreamernyc, I tore, just very minimally - trust me, my epi had worn off before they stitched me up! Baby was 7lbs 6oz. I completely credit the nurse, she basically oiled and stretched me out gradually.

[Deleted]

I had one because I labored flat on my back the entire time and never got up to move around to help him descend into position and he had a large head that couldn't pass through my hips while pushing on my back (not a natural position for baby to pass). My doctor never gave me an option to try anything else and I'd only been pushing for an hour and half and there was no sign DS was in distress. Just said he was going to do and then did it before I could respond. It took me eight weeks to heal from it, was horrible, and is one of the primary reasons I want to go med free this time... so I can be mobile and push in any other position than on my back.

DS was 7 pounds exactly.

[lalamomma]

I tore pretty bad. It took her a bit to stitch me up but I had the epidural. They took there time massaging and such but when I pushed DD decided to shove an arm out instead of letting it come out like normal. I knew that was bad because the nurse looked at the doctor with a funny side eye. Then just how long it took her to stitch. I overdid it early after leaving the hospital and got very sore again but otherwise it wasn't bad. I used the ice packs and tucks and sitz baths and I rarely took anything more than Tylenol even the day of delivery.

[ladysif]

I had one and maybe I'm in the minority but I was totally fine with it! Not a bad experience.

DS1 was 8 lbs 1 ounce and fetal distress (low heart rate) because of the umbilical cord around his neck. I was told I had 10 minutes to get him out or we'd go to c-section, I was prepped for c-section and they had the forceps and vacuum there to use. Dr. numbed me up down there, no ring of fire so pushing felt AMAZING. He knew I was already okay with an episiotomy if need be so didn't ask when he did it. A family member worked for an OB for a long time and having discussed it with her, I wasn't nervous about it. Yes, natural tears have apparently been proven to heal faster and be the better route, but an episiotomy is a clean cut and heals well as such. I think the trend away from them is because an episiotomy might be more than you'd tear - for example, you'd only have a first degree tear without it, but maybe received it and it was a second degree. He just used a blunt-nosed scissors, ended up being a second-degree cut for me. I heard the snip, didn't feel a thing, and next push he was out. Dr. stitched me up, strongly advised me to go nowhere NEAR the area with a mirror for at least 6 weeks, and it was all good.

Recovery wasn't bad at all from the episiotomy. I used the donut at home for a couple days, the ice pack pads from the hospital were fantastic and enough to keep me comfortable. I know they stayed on top of giving me tylenol in the hospital and that helped too those first two days.

Long-term recovery, sex was awkward for a while, but I think it would be the same regardless of episiotomy or tear - you have a scar, they don't stretch the way normal skin does. It took a long while for it to feel good again but it is fine now.

[sugarbean17]

2 vaginal deliveries, no episiotomy for either one. I talked to my OB before hand he said that it had been over a year since he had done one. I had a small scratch like tear with DD they put one stitch in. She was 8lbs 15oz. With DS I had no tearing at all he even had some shoulder distotia -sp? They were able to change my position slightly to get him out. My hubby and I started perineum massage about a month before each birth a few times a week and the OB did it while I was pushing/crowning. It helps a lot.

[Deleted]

I would explain your concerns to your doctor. From what I understand doctors try to avoid doing episiotomies since your body heals more easily if it naturally tears a little instead of being surgically cut. My doctor did not do one on me so I just tore naturally and after birth I received stitches. The recovery was normal and to be expected from a vaginal delivery. The tucks witch hazel cooling pads the hospital gives you and the lidocaine numbing spray helped a lot as well in the recovery process to ease the swelling.

[leenziepops]

Thanks for sharing STMs. But I got crotch cringes reading about all the tears and snips.

[lalamomma]

Apr 22, 2015 2:03:40 GMT -5 leenziepops said:

Thanks for sharing STMs. But I got crotch cringes reading about all the tears and snips.

Even though it wasn't that bad, reading about it and thinking about it freaks me out. I hate needles so the idea of cutting or tearing flesh makes me want to be sick... But really not seeing it was helpful
I did not follow the "don't use a mirror to look" suggestion because I'm curious like that and yeah... I wish I hadn't done that lol!

[noeliav]

No episiotomy. 6lbs baby. One labial tear when passing her shoulders. Healed easily and you cannot even tell now, lol.

[veggiemo]

I had 3rd degree tear and an episiotomy, 7lb 4oz baby. I'm not sure where exactly they cut me, to be honest. I asked my hospital ahead of time if they do them and they said "not unless it is medically necessary". I'm not even sure why mine needed to be done, but everything has healed up just fine. The thing that hurt the worst during recovery was my anus (sorry to get personal) but that hurt a lot longer than my vaginal tears/cuts.

My cousin did not have an episiotomy and she also had a pretty bad 3rd degree tear. She has not healed up well at all and almost a year later she's still having discomfort and she said it looks pretty bad too. When the doc was sewing her up, she said he kept shaking his head and saying "I should have done an episiotomy, I should have done one". I feel so bad for her.

FYI: I had read before not to look down there after birth unless you have to. I never did look because I was afraid if I did, it would cause me more pain knowing what it looked like. My recovery overall was not an easy one, I couldn't sit both cheeks on the toilet for almost 6 months after, because it stretched everything too much. Yowsa.

[noeliav]

I think I looked a week or two after delivery... It wasn't bad, per se, but the stitches were, um, sad. lol.

And ouch veggiemo Ouch.

[belle0720]

Thanks for sharing STMs. Holy crap though, I'm getting scared!

[noeliav]

pghtruelove
Man, mama. All the hugs.
(now that I've gone back and read the entire thread.)

[ladymouse]

Thanks for sharing, all. My first was a c-section, so I don't have experience with either. But I am very glad that the hospital I'm going to does not do routine episiotomies.

[junch817]

billyhorrible I know during labor there is pain on top on pain on top of pain, but tell me about the perineal massage? Did it hurt so freaking bad?? Obviously it helped for you, but still.
And does anyone (DH) do those now to help loosen and stretch things down there?

[noeliav]

My nurses and OB "massaged" (and oiled, actually) as DD crowned. I was preoccupied with the bone/hip pressure/pain to even notice.

We asked about perineal massage during pregnancy and our MWs said that there's really no evidence that it does any good, whereas the massage during delivery does.

[billyhorrible]

junch817 - the massage? It didn't hurt at all. Basically she just oiled up her hand and kept rubbing it circularly around and around, stretching everything a little wider each time, but not enough to cause discomfort. Don't forget, by that time the baby's at a fairly low position, so everything is already stretching out to accommodate.

I can't comment on doing it before labor though, or how that would work. I had the benefit of a baby pushing down and out to help.