response 1 of 11:

Dec 27 19:04 UTC 1994

Episiotomies can *usually* be avoided if you begin preparation soon
enough.  The idea is to increase the elsticity of the perinium through
moisture, stretching, and increased blood circulation.  It depends in part,
of course, on the skill of the doctor who did the first 3 incisions, too.
If you have a great deal of heavy scarring, it probably won't be possible
to loosen the scar tissue up sufficiently.

The steps:

        1) a couple times a day, massage your perinium with oil,
           either vitamin E or vegetable.  Use your fingers to
           stretch the tissue out and down.  (You might find it's
           a great deal easier for your hu
           manage that one; I did.)  Pulljust until you feel
           some stretching, but well before it hurts.

        2) spend some time every day with no panties.  Air circulation
           with help make the perinial tissue healthier.

        3) practice squatting as low as you can.  The stretch will help
           increase the blood flow to the area.  It helps if you can start this
           one        early in pregnancy to minimize the strain on your joints,
           but
        if its too late for that and your knees just won't take deep
           knee bends, try sitting in a lotus position and bending forward as
           far as possible.

And good luck with your Dr.  He may actually be the bighurdle you have to
jump.  Since the exercises can only help. and the size of the child and the
speed of the delivery also play a role you'll have to trust his judgement,
which may be more conservative than you'd prefer.

You may want to consider having a midwife or duoala in attendance, too.

response 3 of 11:

Dec 28 14:46 UTC 1994

I'm not big on company or distractions in labor, my husband is enough--
he knows when to reassure and when to sit down and shut up.
A midwife is not practical--I'm high risk:  I get diabetes during 
pregnancy (gestational diabetes), which ends with delivery but in 
the meanwhile there is risk to me & baby.  I'm on insulin  shots
once I get along a bit into pregnancy, and for that reason, must be 
hooked up to an IV.  ALso, if the babies aren't born early on  their
owon, they must be induced.  (I'm lucky--the 1st 2 were early, and #3
was induced so skillfully there was no pain for all but the last hour!)

My 1st 2 epesiotomies were done by a different doctor than the third.

My babies are not huge ins spite of the diabetes...alll 7.5 lbs or less.

My doctor has seen me through not only the diabetes, but also a 
miscarriage, and was so wonderful helping me with some nasty hospital 
procedures and staff so I'd be less miserable.

Given all tis, is it worth trying for an epesiotomy-free delivery?

response 5 of 11:

Dec 29 15:13 UTC 1994

I've only just found out I'm pregnant so I haven't been to my dr. yet
By my estimate, the end of Aug. (yucch!)

Thanks!

response 7 of 11:

Jan 2 03:45 UTC 1995

Work hard at lasting till the end of August (our maddening,
delightful child born on July 12, 1990 was due on August 24).
But about episiotomies: one friend of mine, having just had her
[I think 3rd]  child mentioned something about having a warm 
wet cloth over the perineum for much of the lying-down labor,
to relax the muscles in an attempt to avoid another episiotomy.
(It worked, or something did)  That might not be feasible in 
your high-risk situation, but you could ask your doctor what
he thinks.

response 9 of 11:

Jan 8 02:30 UTC 1995

Keeping my fingers crossed about that bleeding.  Toes, too.

response 11 of 11:

Jan 9 15:54 UTC 1995

Right after my 1st was born, mta, my husband said something similar.
After I had spent a very hungry 16+ hours in labor (and my water 
broke at the beginninng so the hospital had made it worse by confining
me to the bed for fear of nfection), my ever-lovin' husband turned 
to the dr. and said "Wow, one down -- eleven to go!"  I think I passed
out then.

I am lucky--the doctors  I have had, while medically conservative,
are very sensitive people, both men but bery sympathetic to women
they treat.