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Does anyone know much about avoiding epesiotomies? I've had 3 kids so far, and really don't want a 4th epesiotomy. My doctor is really nice and I trust his medical competence, but he's around 60, and I think this is one issue I've got to push on my own. Can I avoid a 4th one? what can I read to get more information? help!
11 responses total.
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.
And, if you end up having an episiotomy, don't forget that it's a lot less painful and inconvenient than torn tissue. Trust me.
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?
Its definitely worth a try, though its important that you express your concerns with your Physician. And of course, the size of the baby, how much scarring there already is, etc. And Misti has severl good suggestions about preparing the perinium. Good luck!! When are you due?
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!
<roz blows ice cold January air to simcha in August, sweating under a maple tree and fanning herself>
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.
I rushed in to see my dr. yesterday because I was bleeding what seemed like buckets. Everything looked okay and so far I haven't miscarried. roz, I'll love that icy air, can you bottle it? having hoped for a spring baby, we have a deposit on a beach place for the middle two weeks of aug!!! somehow, I don't think they'll let me drive 500 miles oops, miles, then! assuming all goes fine gien the bleeding. my formal 1st visit is next week. grace, do I really WANT to last til the end of Aug???! Thanks for the epesiotomy advice, too.
Keeping my fingers crossed about that bleeding. Toes, too.
A midwife can be an advocate for you while your doctor handles the high risk aspects of your labor, simcha, but if you don't tolerate company well during labor it may not be worth it. (I had a couple of midwives, a dear friend, my older child and my husbad there fir my second child's birth -- but then I cracked jokes right through transition, too. I get very high and social during labor. Had a bit of a time convincing anyone I was in second stage labor until Corey crowned. ;) I thought my huband was gonna kill me when I turned to him right after the baby was bom, smiled beatifically (sp?) and said "That was fun. Can we do it again?" <laugh> He never did have much of a sense of humour.
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.
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