2Nd Child's Delivery

Why would you not want an episiotomy? I thought they were the norm!!! I had one with both of my kids, and never had any issues, not with changes in my you know whatsky down there or anything!! :)

Hi K.,
I did perineal massage at the end of both of my pregnancies. Didn't have one tear. Both of my children came quick as well. My second came about an hour after my first contraction! Big babies too, 9lbs & 8lbs.
I think it's true what one mom wrote about having a provider who knows to protect the perineum. With my first they wanted to do an episiotomy but my midwife said no. So glad I had her on my side. Again my first child was 9lbs.
I suggested massage to a friend with her second and she also did amazingly well.
Whatever you decide good luck to you.

Your best two bets to protect from tearing are staying off your back (deliver in an upright position) and having a provider you knows to protect your perineum (there are several no invasive techniques that can be used, as well as lube and warm compresses).
Since you can control pushing much better without an epidural, staying unmedicated is also helpful.

Good for you for not opting for an episiotomy. Several recent studies prove that they do not heal faster and are likely to result in even more severe birth injuries (3rd and 4th degree tears).
Good luck!

Hi K.,
I found with my second that everything went easier. It isn't always the case, but often. Even if you might tear, I would not recommend an episiotomy. You heal better with a natural tear. Have you heard of Henci Goer's book called "The Thinking Woman's Guide to a Better Birth"? I highly recommend it. She covers all the "normal" hospital procedures and what the science/experience actually indicates for a better birth, rather than what most doctors do. About a third of the book is her appendix, which lists all of her resources she used in the book. Excellent! Best wishes! My recovery with #2 was way easier than with #1 (I have 6 altogether!).

I had exactly the same situation - tore with my first after a quick delivery of about 3 pushes. I really thought it was because I was on my back, and holding my breath. This time I breathed through the pushing and was on all fours. Still tore about as much. I did not use perineal massage. I guess it couldn't hurt, but I think the benefits are more anecdotal than anything. I think all births are different because all moms/babies/positions are different. The main thing would be someone supporting your perineum with a warm washcloth, lube, stretching, and a slower delivery. I did recover faster this time, FWIW. Also, congrats to you for not wanting an episiotomy. I am still glad I didn't get one even though I tore with both.

SInce you said you only tore moderately, I would venture to guess that it happened because you were lucky enough to only have to push 3 times and the skin did not have enough time to fully stretch! Sometimes this is unavoidable.

But, there are a few things you can do. First, ask your nurse or practitioner to apply warm compresses to your perineal area for 5-10 minutes before you are pushing (sometimes hard to figure that out!). This can help make the tissue more pliable. Second, avoid pushing and having baby crown while on your back - being on your side or hands and knees can lessen the pressure on the perineum (the most llikely spot to tear). Third, instead of pushing really hard while holding your breath, breathe baby down or use gentle shoves to ease baby through crowing. It takes a ton of control to do this but makes a very big difference.

Congratulations!

If it seems like you might tear - you are better off with an episotomy - cleaner edges to stitch back together...Perineal massage can help - but if you have fast deliveries - you do have a higher likelihood of tearing.

Hi K.:

Congratulations on baby #2! You can keep the area or original tearing lubricated and supple with Aromatherapy support (try Jojoba oil) and keep your body hydrated. Ideal water intake is distilled water - 1/2 your body's weight in ounces, so if you weigh 180 pounds, 90 ounces per day. You can get started here.

All the best,
N.
Founder/Organic Mommy & Baby Healthcare Solutions
www.WholeCreations.com

i hear episiotomy is more difficult to heal.
I tore in both, much less the 2nd time.
we didn't do any massage stuff but i guess after my my epidural my dr did something i'd rather not know about. LOL
hemroids way worse however.

Spiritual Midwifery by Ina May Gaskin has helpful and effective suggestions. I applied several and had no tear to speak of.

Is it the same doctor doing the delivery this time? Are you opposed to an episiotomy in advance or to having an episiotomy if you look like you're about to tear? Basically, I'm wondering if you don't want an episiotomy under any circumstance or if you just don't want your doctor to do one unless you absolutly need it to avoid tearing? Episiotomies are not something that any reputable doctor just "does," like starting an IV just in case it might be necessary to use it. Episiotomies should be done as an alternative to allowing a woman to tear, while she's actively pushing and the baby is starting to crown. I would think that an episiotomy would be preferable to tearing, especially to someone who has already experienced healing after a tear, since it's a clean cut and easily stitched for much quicker, easier healing. My doctor gave me an episiotomy while I was catching my breath in between pushes on the same contraction, because he knew I was going to tear otherwise and I'm SO glad he was responsible, aware and proactive enough to do so.

I had an episiotomy and tore with my first my 2nd was the exact same size but 1 oz lighter and I didnt tear with him. all pregnancys and deliveries and kids are diffrent.