Episiotomy? - Phoenix,AZ

I have two sons and with one, I tore just before they could cut, and the second one, I had an episiotomy. My first one, I was more sore down there for 4-6 weeks, where as with my second, only about 2. For me, but the time that it came to that, I was in so much pain, that I didn't feel or notice the difference, just that I was told what was going on. Good luck!

Well I had one with both, it is just a cut they make so that you don't tear. They only do this if needed. You do not always need one. We stretch pretty far down there when it comes to having kids. Some doctors will do an episiotomy if the skin gets to where it will tear and some will let you tear. I had an episiotomy with my second son all the way to my anus as he had a 36cm head. Anyhow, don't be afraid of them. On my first child I had only 1 stitch from a small episiotomy. I don't even want to know how many I had with the second, I just know she was sewing and I wasn't too worried.

D. P.

It really all depends on the person. Some women stretch enough so that not everybody needs one, and not everybody tears. An episiotomy is better than ripping though. I would think that it is done as an as needed basis and that call is made at the time. I had to have one and the recovery isn't too bad. Hopefully you won't need one, but if you need one it is better than ripping. Congrats on you upcoming arrival!

The best laid plans just don't always turn out the way you want them to! I delivered in 3 pushes and less than 45 minutes! The doc did an episiotomy and I didn't even know it! As long as you trust your doctor, let the decision be made by him/her.

I had an episiotomy. In my birth plan I said let me tear. Because I had heard you heal better. However my daughter was very stuck and I was very close to a Csection. I was not tearing and they were worried for her and my health so I agreed to one. It was large. Not sure how many stitches as according to the OB "I lost count after 25".
I am thankful I made that decision then because I prefer that over a Csection. However the healing took 8 weeks before I could walk around the grocery store without having to lie down afterward for a few hours.
I would put in your birth plan no. But be ready to have your birth plan thrown out the window. It may go smoothly it may not. Just be prepared for anything.
We are expecting our second and I will put that I do not want one with this baby as well but if it comes to it then I would rather have that with a healthy baby than anything else.
Good luck to you.

I have experience on both sides.....
With my oldest daughter who was 8lbs and 1oz, they gave me the episiotomy and was also forceps delivered. (THANK GOD)

With my youngest daughter who was 5lbs and 9oz, they did not because she was so small. Would have been a good thing but she decided that she wanted to come out looking up at the ceiling so I ended up tearing anyway. (was too late to cut me to prevent tearing)

I would have rather dealt with the cut.

Here's the truth about episiotomy. Although it shouldn't be a routine procedure because many women do not need it to deliver vaginally (most times the tissue will stretch and tear only slightly at the vaginal opening), it is sometimes necessary to speed the delivery of the baby (in cases of fetal distress) or to prevent extensive tearing of the perineum or vaginal tissue. The straight cut from an episiotomy is sometimes easier to repair than a jagged tear should that occur. I had an episiotomy with my first child (almost 9 lbs) and had a small tear with my 2nd and 3rd children. They all healed just fine. Obviously, it would be nice not to need an episiotomy, but please understand that sometimes they are necessary. In my practice as a midwife I did very few episiotomies because they just weren't usually necessary when the delivery/pushing were slow and controlled. I think you need to discuss with your Dr your desire to avoid an episiotomy, but allow your Dr the freedom to do and episiotomy should she or he think that it is necessary for a safe and healthy delivery. Sometimes it is the best decision for mother and baby. Best wishes and Congrats on your pregnancy. R., nurse midwife mom of 3

From what I understand, they don't do episitomies very often anymore because it is better in most cases to tear naturally. I would check with your Dr. or do some research on it. I tore with both my kids and healed fine. The tears are very small, I would never known they were there if the Dr. hadn't told me. BTW . . . my sencond was 9lbs and I did not tear, so it doesn't always matter how big the baby is. And she was my easy birth, go figure!

Be prepared for a lot of opinions. This topic is almost as debated as "natural" birth verses hospital intervention.

I'll tell you what my doctor told me. In Europe they do almost no episiotomies but they do perineal massage the last month or more before birth - stretching out the vagina. Here in the states we do episiotomies. Both sides feel their way is the best. Both sides have pros and cons. In Europe the number of women that have a surgery to "tighten" their vagina back up is MUCH higher then here in the states. He was very pro-episiotomy. He had been delivering babies for 30 years, and he said he saw one woman tear up into her clitoris. Instead of tearing down, she tore up. He said it was very painful and affected her sex life later.

I changed insurance and have a different OB now. My current doctor does not do an episiotomy unless it's needed. He watched the situation and makes the best judgement call he can. I trust him - so that works for me. My third child I didn't need one.

I'm not for or against. Just giving you the info that was given to me. I've had an episiotomy twice. Both healed easily, no complications. In the distraction of having the baby and taking care of a newborn - it wasn't really something I even thought about.

Good luck.

I had a birth plan that stated I didn't want an episiotomy unless absolutely necessary. I discussed it with my OB who said she didn't do them very routinely (I don't think they're very common anymore anyway). However, during the pushing phase of my labor, my OB observed that I was about to tear horizontally which would be pretty severe so she suggested that she cut me to prevent that from happening. Honestly, by that point, I was so exhausted I didn't really care what happened... I just wanted the baby out! So, I had one and she stitched me up right after my daughter was born. It was uncomfortable but livable. Also, the healing part wasn't terrible. Certainly it was slightly painful but I took some medicine and was fine.

In essence, all the current research I read stated that tearing on your own is (for the most part) preferable to a surgical cut, but it depends on how you tear.

Good luck!

I think it really depends on the situation. I had small tears with both of my boys-they were uncomfortable but healed fairly quickly-they were both 8 lbs even early and had big heads and I'm a small person. My doctor used oil and perineal massage during delivery and I truly believed it made the difference. A cousin had a nearly 10 lb baby that got stuck and had to be suctioned out and she had third degree tears that took months to heal. Had she had her doctor and not the resident she would have likely had an episiotomy and healed much faster. Every woman/baby is different so make sure you have a doctor you trust and discuss the options with him. I wouldn't plan on one but leave it as an option if absolutely necessary.

Get one if you need one, but you just won't know until you are at that point. It is a judgement call for your doctor, and I would let them know that you trust them to make the call.

I had an episiotomy with my first two deliveries, and for some reason, my last doctor let me rip instead with my third. It was much more painful and took a lot longer to recover from the rip, and I would take the surgical cut over the rip any day.

M.

Episiotomy is ALMOST NEVER NEEDED, and when it is done it usually results in worse tearing than a natural tear (which is almost always superficial and mends without stitches). The ONLY time your doc should be doing an episiotomy is in a real obstetrical emergency, which almost never occurs. To avoid both episiotomy and tearing, find a doctor with a low episiotomy rate, practice perineal massage, try to birth as unmedicated as possible, and get off your back for labor and birth - find upright positions to birth in (squatting, side-lying, hands-and-knees). Read up on it with some good birth books. Good luck!

I had both in the same delivery....the thing is I was insistent that I did not want an episiotomy but after pushing for an hour and a half it was clear I was going to tear or have to get an episiotomy...I elected the episiotomy so the delivery could end.....otherwise it was going to last a while longer while I waited for my body to tear...issue was i still tore further. The spray and tuck pads the hospital gave me to use did not hurt at all....just know that your birth plan is only a guide and may change...my advice would be to indicate you only want an episiotomy if necessary and then see if you even need one!

Good luck!

Hi J.-

My first child was 10 lbs. 15 oz and I tore. I needed stitchs and let's just say it was a little tender down there for a few days but it wasn't that bad. I would talk to your doctor but I don't think I would ever "plan" on having an episiotomy.

Good luck,
K.

Talk to your doctor. Most of them have varying opinions, but the most recent thinking is that they will just let you tear if it's going to be minor and only do an episiotomy if the tearing would be major. I had two children vaginally and tore a very small amount with both. No episiotomies needed and minimal stitching. Just ask whoever is going to be delivering your baby what their standard procedure is. If you tear BADLY -yes -it's worse than an episiotomy because those are precise surgical cuts that are easier to stitch. If you only tear a little -an episiotomy is worse because it often cuts you more and more deeply than the tear would have been.

When I had my first baby I was always told they were awful and you should insist that your doctor not give you one because of this reason... or because of that reason.... but I have very large babies and during delivery my doctor said, "Okay, I know you really weren't okay with this but we are going to need to do a minor episiotomy to keep you from tearing pretty badly, okay?" And I said okay, because I knew how big my son was and I didn't want to risk a deep tear.

It was the best! I know that sounds insane, but as soon as he did it, I felt so much relief from the pressure, it felt so much better.

After we went home I was uncomfortable because I was stitched up - but that would have happened anyway. After a few days I felt much better considering....

Congratulations and best of luck to you! Its really not bad I promise!

Hi! I did not read all of your responses so I am sorry if this has already been said. I really did not want an episiotomy but I had one when the doctor suggested it. From what I understand, a tear is a risk because you can't control where it tears or how much. Damage that may affect your life afterwards can be done. The doctor attempts to make a cut that will help get the baby out but can spare you any damage that a tear can cause. Some good advice I received was to not scrimp on any pain relief offered at the hospital afterwards. They provided medicated pads and a spray. I used a generous amount and asked for more before I left the hospital. My husband also purchased more at the pharmacy. Best wishes on a healthy and happy birth experience!

I had an episiotomy with my first 2 kiddos. With my 3rd one, I did a birthing plan and wrote in it that I would like an episiotomy. Well, when the time came, he wouldn't do it stating that the tear would heal faster. Looking back, I don't know if it really mattered one way or the other pain-wise. First epi hurt mildly for a long time, second epi hardly hurt at all, third natural tear hurt alot for a few days but then went away.

I would, like the other posters said, leave that up to your doctor unless he asks during delivery (I was asked with my 2nd and did request at that time).

Good luck!

Talk to your doctor. I talked to mine about how I wanted to avoid an episiotomy and ripping if at all possible. I gave birth to a 8 lb 3 oz baby at 42 weeks. The doctor used oil. I have heard some use olive oil, he used a mineral oil and lubricated the area really well as I was delivering. No cut and no tearing. I am about to deliver again in June and hope for the same experience. I wish you all the best with your delivery.

I am also not for or against them. I told the doctor who delivered me to only do it if necessary. She was fine with that, and she wasn't even my regular doctor that I had discussed it with, but the on call doctor from the practice. I pushed actively for a little over 2 hours, and she did perineal massage the whole time. When it came time, she said I was going to tear if she didn't do it, and it looked like it could be a good size tear. So I let her. She did a very small incision, it only required a few stitches. It healed perfectly and I have had no issues with it. No scar tissue or anything. I know a lot of people are adamantly against them, but personally I will do the same thing next time- wait and see if it is necessary and only do it if it is. I was very fortunate to find doctors that I trust absolutely, and everything went very well with mine.

Good luck!

This is personal experience, which is different for each person obviously. I had an episiotomy with my first delivery. My son was only 7 pounds, but because of the epidural I was having trouble pushing. The incision was made almost to my butt. It burned and itched horribly for days. Peeing hurt. After my six weeks healing time was up, the scar had made it tight. I couldn't have sex for awhile, every time we tried it hurt too much. It had to stretch back out before sex was normal again. And for awhile after that, it would make me flinch because I was expecting it to hurt. When I had my second son, I went all natural. He was 9 pounds, and I ended up tearing. But it was tiny. It itched a little, but it was nothing major and I was walking around 2 hours after he was born. When my 6 weeks was up, sex was perfectly normal. No pain, no problems. The doctor will make the call that he feels is best in the situation, but don't go into it asking for one. Because they will do it if you ask them to, whether you need it or not. Just see how things go.

Just so you know with an episiotomy they cut through the skin AND the muscle. With a tear it is (most generally) the skin. Some tears will not require stitches (I had two small tears that did not require stitches and they healed very quickly...I think one was gone before I left the hospital). With episiotomy you will have to get stitches and that means there is a recovery time. I did not have one (I talked to my doctor about it and they said they would not do it unless it was absolutely necessary), so I can't say personally how bad it was. But my mom told me that with her stitches (she had one with my brother) she could not go poo comfortably for a while afterward. There are 'stretches' your partner can do (you can do them to with a mirror, but it is more difficult) to help make the skin down there more flexible and less likely to rip.

Giving birth is traumatic for your body, no doubt, but I feel your body knows what needs to happen more than doctors.

When I gave birth to my daughter I had asked my OB only ot do one if it seemed like i was going to tear. I would always have as an option because if you tear, it can be in multiple places and cause more stitches then if they cut. It turned out I didnt need one and only had a couple of stitches, but I let my OB know only do it if it seems nessecary.

I ended up ripping . I did not feel a thing, I was all natural (I was surprised).I only needed 3 stitches.
. I have had a few friends that ripped or had to have long a episiotomy all the way and really had a long healing process. but also had a friend that home birth and just ripped the whole way. (3rd degree tear) she say on a cushion and ice for a long while.

I told my doctor, I was willing to try natural for everything. But I wanted to have all options available. It worked out that my husband was a great coach, the nursing staff was extremely helpful, I followed all of their suggestions and it just all went really well. Our daughter was in distress during labor at one point, but they were able to make some suggestions, I just told them to do whatever needed to be done to help her.

With my first child, I pushed for about an hour and he was close to crowning for some time but the tissue just wasn't stretching. I remember the OB using his fingers to massage and try to assist the stretching but it wasn't working and he ended up doing an episiotomy. The incision took about a week to heal and I will not lie, it hurt! It was swollen &sore, I had to sit a certain way so as not to put pressure on the area, and I had to take stool softeners to make bowel movements more bearable. I was given some spray antiseptic with lidocaine which helped to ease the discomfort. It stings like crazy right after you put it on but then it numbs the area pretty well. My second delivery went so quickly that I tore and it had to be sutured.

I would honestly say that I had the same amount of discomfort with the tearing as I had with the episiotomy and it took about a week to heal with both. Either way, the tissue is going to be traumatized and sutures are involved. As long as you discuss your preferences with the dr ahead of time, I would trust them to make an appropriate decision when the time comes as to whether or not an episiotomy is necessary. Some women do not tear or need an episiotomy and it's possible that this won't even be an issue for you. Best wishes! :)

I didn't get one... my nurse midwife just used oil and massage and I didn't rip with my 10lb baby. It's not like back in the couple of decades where most doctors didn't wait and just shoved forceps up and yanked.

WIth my first son, he was 8 lbs. 12 oz and I pushed for almost 2 1/2 hours. My OB was preparing to give me one (which I wasn't a fan of- even though I felt nothing as the epidural really did its job, but just the thought of being cut freaked me out a bit...) As it turns out, I was able to push him out and did end up with a 2nd degree tear, but never felt anything. I've heard that a natural tear actually heals better than an episiotomy... but I was willing to do whatever it took to have him be born safely. They also considered using forceps, and would have preferred the epis. before forceps...

My advice would be to tell them you prefer it not unless absolutely necessary (which I would think is the only reason they'd do one)... it's still better than a C-Section and when you're in the middle of delivery, the focus is a healthy birth. Good luck!

I've had tearing and an episiotomy. Both required quite a few stitches and the healing time was about the same for both. I didn't notice that one was more painful than the other. They were both very uncomfortable for about 2 weeks. It really makes no sense to me that one would hurt more than the other. You are not always given a choice when a baby is in distress. My second son was so big that the doctor just said, "I have to cut you," and did it before I could even respond. It was for the safety of my son, so he could be delivered unharmed. Hopefully, you have trust in your obgyn and will rely on his/her knowledge and experience to make the best decisions for you and your baby. Births rarely go exactly as planned, so make your plan very flexible or it may just lead to disappointment. Good luck!

I had one and not by choice. My dr. just did it while I was pushing. I didn't feel it and I didn't rip which i'm sure would have sucked. I hurt obviously for a few days but it healed nicely and i'm fine. I wouldn't worry about. Many, many women get it done. They give you stuff to keep it comfortable, like witchhazle pads and meds.

i didn't have one, and didn't tear either. you might not need one!

I think the general consensus among doctors (right now, anyway) is that a tear will heal more quickly than an episiotomy. There's also the possibility that the OB could cut you when it might not have been necessary.

Really, I would leave this one to your doctor's judgement. Assuming you trust him/her, of course...

I had an episiotomy with my first... No rips or cuts with my second... A slight tear with my third... And waiting to see about the fourth... (due 5 days ago)...

I had the WORST time healing from the cut... That is when I realized that every body part connects to everyother body part right "down there" :-)

My one aunt had a horrendous tear...

I personally would much rather tear than be cut again... But that is just me.
Typically your dr will not cut unless they see a need... Sometimes they cut seconds AFTER a tear so you could end up with both...

My suggestion would be to use the tub during labor. It helps relax you and helps keep things down there pliant.

Keep your birth plan flexible and do not expect it to be followed... I never even bothered... Do what you feel like doing during labor and don't sweat the things that could be a nonissue... But also be prepared for those nonissues. lol Sounds confusing right? I can not think of a single woman who would WANT an episiotomy... So just say that your preference would be......

I did not tear or have an episiotomy. My doctor did the perenial massage when I was in labor and I think that helped me from tearing or needing the episiotomy. I was in labor for about 3 1/2 hours. My daughter was 7lbs. I think there are a lot of factors that go into it and each mother and baby are different so I think each persons experience is different. I do believe the perenial massage helps though.