Episiotomy to prevent tearing? Opinions anyone?

[kate1984]

My vagina and scissors will never mix, that said this is number 5 and I didn't tear with the other 4

 

[Feronia]

I
And it's not a question of 4th degree tear vs. episiotomy. Many women who receive an episiotomy wouldn't have teared (or only would have had a minor tear) otherwise.

No, it's a question of avoiding a SECOND major tear by having an episiotomy. It sounds like you've never had a major tear so perhaps can't understand how traumatic they are. The OP was specifically asking about getting an episiotomy to avoid a second tear. I am sure the OP would prefer to avoid both tearing and episiotomy, and the advice you shared about position and water birth is helpful in that regard.

But once you have had skin, muscles and organs stitched back up, and underwent a long healing process, you aren't eager to go there again. If I had torn the same areas again, I don't think I would have healed so well.

I'm aware of the OPs question, and my response is the same; even though scar tissue is not as pliable as perennial tissue, you aren't guaranteed to tear. I'm a doula, and I've known of clients in my area who had 3rd and 4th degree tears in one birth, no episiotomy in the next and only very minor tears (or no tears at all) that don't require stitches. Healing from a minor tear is much better than healing from an episiotomy, and you're less likely to tear in subsequent births anyway.

That really sucks that they try to make you give birth on your back in China! I don't know the laws in China, but at least in North America and the UK you can always refuse something, even if it's made out to be "mandatory."

 

[Beanonorder]

Well I initially refused so I'm sure they can too! But as they only ever have one child and they do it all alone I don't think it occurs to them to say no. Its basically a case of 'well everyone else does it' and a lack of education.

 

[josephine3]

Yeah mayb i should have been specific that im worried about tearing into the same area again and worry that the muscles will be weaker there. I should add that my first was a water birth and i still tore badly! I also think it actually contributed to my tear by lack of control, lack of counterpressure and no guidance thru the pushing phase. I also pushed for 2 hrs tbh im leaning towards on my back this time it cant be much worse! I wudnt be allowed to use the pool again even if i wanted to because of the tear and heamorrhage.
Gosh anything can cause a debate on bnb!

 

[teal]

Yeah mayb i should have been specific that im worried about tearing into the same area again and worry that the muscles will be weaker there. I should add that my first was a water birth and i still tore badly! I also think it actually contributed to my tear by lack of control, lack of counterpressure and no guidance thru the pushing phase. I also pushed for 2 hrs tbh im leaning towards on my back this time it cant be much worse! I wudnt be allowed to use the pool again even if i wanted to because of the tear and heamorrhage.
Gosh anything can cause a debate on bnb!

I had a check with my consultant at 8 weeks post and his concerns was that while I've healed quite well this time if I tore again they wouldn't be able to repair the damage as well. I had an episiotomy, separate 4th degree tear. There was also the concern of tearing between the two scars. I was recommended a section if I ever had another baby but to be honest the birth and recovery had put me off.

Good luck xx

 

[Warby]

Have you talked about it with your doctor/midwife? What did they suggest?

 

[clairebear0]

With second babies you tear less.

My doctor said he basically would judge how you are tearing to determine if it is a good idea to get an episiotomy...for example, if I was going to tear my clitoris or something he would want to give me an episiotomy. I think you should talk with your doctor about what your wishes are so they are clear.

 

[josephine3]

Yeah iv spoken to a doctor she said she thinks i would be ok to deliver vaginally but couldnt really give me any advice on the episiotomy. Just that they normally have a 'high threshold' for performing an episiotomy and she could write on my notes i requested a 'low threshold'...

I cant imagine anyone tearing 'up' towards the clitoris??!

 

[Seity]

No, no, and no. They won't even do them at my hospital except in a medical emergency because they know you are much better off tearing, if it's going to happen.

 

[smileyfaces]

I had an episiotomy first time round and can honestly say it is much easier just to tear naturally. The recovery from an episiotomy compared to the second degree tear I got with my second pregnancy was much more painful! Id avoid an episiotomy if possible!

 

[roomaloo]

I had a forceps delivery first time. They DESTROYED my perineum with an episiotomy. I have a rectocele as a result and am waiting to have reconstructive surgery

Had a home birth second time and had a first degree tear. So you aren't guaranteed to tear along a previous scar, and mine is front to back