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EPISIOTOMY VS. TEARING
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EPISIOTOMY VS. TEARING

HELLO AGAIN,
COULD SOMEONE PLEASE TELL ME IF AN EPISIOTOMY IS BETTER THAN A TEAR?  MY DOCTOR SEEMS TO THINK SO. I WANTED TO KNOW WHAT IS THE DEGREE THAT THE AVERAGE EPISIOTOMY IS CUT?  I DELIVERED A 6LB 10OZ BABY 4 MONTHS AGO AND ENDED UP WITH A DEEP 2ND DEGREE TEAR AFTER REFUSING AN EPISIOTOMY. I WOULD THINK THAT IF I TORE SO BADLY WITHOUT A CUT, I WOULD BE IN DIAPERS NOW IF SHE HAD CUT ME?
MY DOCTOR REFUSED ME ANY PAIN MEDICATION AND GAVE ME THE OPTION OF, "EPIDURAL OR SUFFER".  I CHOSE "SUFFER" SINCE I DID NOT WANT AN EPIDURAL AFTER SEEING TOO MANY HORRIBLE SIDE EFFECTS IN FRIENDS AND RELATIVES, SO WHEN I SAW MY DOCTOR COMING AT ME WITH A PAIR OF SCISSORS BIGGER THAN ANYTHING I HAVE IN MY HOME, FEAR TOOK OVER AND I DEMANDED THAT SHE NOT CUT ME!!  SHE WENT BALLISTIC ON ME AND I AM SURE THAT SHE LET ME TEAR. COULD THIS TEAR HAVE BEEN PREVENTED OR MINIMIZED? I DELIVERED ON MY BACK WITH MY KNEES PULLED UP TO MY SHOULDERS.  I HAD LABOR AUGMENTED WITH PITOCIN, SO AFTER ONLY 3 BLUE FACED PUSHES, MY SON WAS BORN AND I HAD A HORRIBLE TEAR. NO PAIN MEDS OFFERED FOR THE REPAIR EITHER!.  I SUFFERED HORRIBLY FOR 2 MONTHS AFTERWARD AND I AM STILL IN PAIN.  IS THIS NORMAL??  I WANT A SISTER OR BROTHER FOR MY SON AND I AM SCARED THIS SAME THING WILL HAPPEN TO ME AGAIN.  THE REPAIR WAS HASTY AND CRUEL AND LOOKS FRANKENSTINIAN.  I AM 36 AND MY DOCTOR REFERS TO ME AS A GERIATRIC MOTHER, SO I THINK TIME IS RUNNING OUT FOR MORE BABIES.
THANK YOU FOR ANY ADVICE.
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8 Comments Post a Comment
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Avatar_n_tn
Wow, I'm so sorry, it sounds like you had a horrible experience. I would definiately change doctors and shop around for one w/ your philosopies. Let me assure you that every birth experience is different! The first child is always the hardest to get out, and yes, that area tends to look like some form of hamburger meat afterwards. Now, you should not still be in pain, that would indicate that a second repair might be in need. As far as your age goes, you are considered "high risk" or "advanced maternal age" starting at 35. I would not let that scare you, it just means that they are going to take extra precautions. My personel experience is that you can become a mother later in life, it's weather or not you have the physical energy to keep up w/ them once there born! Hope this helps, good luck to you.

Karen in Atlanta, mother of 3
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Avatar_n_tn
Totally agree with kebby, NEW DR fast you have a right to have a birth the way you want it. I do not know if your tear could have been prevented but the doctor certainly didn't do anything to keep it from happening. There are things that could have been done to 1, keep you from tearing 2. keep you from tearing so badly. In my opionion not giving you a local or some type of pain relief was barbaric at best. I have 5 children 24yrs to 6yrs and I am 41 yrs old and my last pregnancy was the best :) You really should be healed by now, you might have something else going on or if you weren't sewed up correctly the first time you might be having secondary tearing. Good luck.
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Avatar_n_tn
I chose to have midwives deliver my first child (and they'll be delivering my 2nd) and thier philosophy about tearing is that it is much better than cutting.  They also recommend a pereneal massage starting around 34 weeks.  It involves using cooking oil and massaging and gently streaching the area so that not as much tearing or cutting is necessary.

I didn't do it the first time (I thought - how gross!) but I will do it this time - since I also had 2nd degree tears.

I agree that you'll DEFINATELY need an OB (or midwife) who shares your beliefs.

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Avatar_n_tn
well since we are all in the sharing mood, I have also experienced both tear and cut, with my first(6yrs ago) I had a cut with anestesia and an epidural too it was great the baby came out smooth  and the dr stitched me up beautifully , the cut was maybe an inch I healed perfectly, okay well I got pregnant 6 months later with my second baby(5yrs ago ) different dr no epidural offered nothing, they made me push and I felt a burning down there so bad like it was on fire I literally felt myself tear as I pushed and hollared my lungs out but they stitchd me up nicely ansd I healed about the same as the first time and at that time I was only 20...I guess they thought because I had just had a baby the previouse year the next one would just slide out plus to top it off I didnt even know I had a chioce !!!!Im pregnant now with my 3rd  and Im putting  my bid in for the scissors... : )
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Avatar_n_tn
I had an epidural and episiotomy with my first child and ended up with a bad 4th degree tear.  I haven't had any more kids yet but I was talking with my new dr and they said definately schedule a C-section for the next delivery. I have done extensive research on the topic on the internet and I've read the same suggestion.

There is a reason why they gave an episiotomy in the first place, to make the baby come out more quickly and easily (and usually it's at the Dr's convenience).  If you don't want to risk further damage then most definately schedule a C-section.   If I would have known that I would have gotten a tear into my sphincter I would have just skipped natural birth all together.  It's one thing to get fulfillment from delivering your child naturally, but the irreversable damage that it caused I still live with to this day and it's had a major effect on my physical, mental and emotional health. My daughter got stuck behind my pubic bone and the dr broke her collarbone just to get her out of me. Does that sound like a good way for her to have entered this world?  Vaginal birth is not worth it, but if you must deliver vaginally, make sure you have a birth plan signed by you and your dr stating that he/she agrees not to give you an episiotomy. And if they STILL do, SUE!  I wish I would have.
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13167_tn?1327197724
Mommy2 - I'm not following what you're saying.  

I'm sorry you had a really bad experience, sounds very painful.

But I don't understand, after your horrible tear, suggesting that those who "insist" on vaginal birth demand that you not have an episiotomy.  

Not sure what was done with your episiotomy,  but the purpose of that procedure is to keep women from going through what you went through.   Outright refusing the procedure will lead to a greater chance of a serious tear.

I have taught labor and delivery.  There are things a mother can do before birth to reduce her chances of needing an episiotomy,  including perineal massage and learning to relax the perineum,  allowing it to stretch more completely.

A small natural tear is easier to heal from than a small episiotomy - because in a tear,  the edges are jagged,  fitting together a little more like a "zipper" when healed,  where a small episiotomy has very smooth surfaces to heal,  which doesn't allow for much overlap and gripping.

The thing is,  a doctor doesn't know ahead of time exactly how much tearing will happen - and a doctor who needs to do an episotomy to get the baby out - which seems like your case because you were unable to deliver - ought not be threatened with a lawsuit for trying to ensure the best outcome for both mother and baby.

If you decide to have a c-section,  you might be surprised that recovering from an incision that cuts through all the muscle layers in your abdomen is not walk in the park either.
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Avatar_f_tn
Hi...
As a first time mom to be I was not worried about the pain of labor, the length, anything, and not really even tearing, just the needle for the anesthtic if i needed to be repaired, so I did alot of research pre-birth, when my hubby wasn't willing at first to do the perineal massage I showed him a video on youtube of an episiotomy and episiotomy repair... he was more than willing that  night!
Needless to sayI had my beautiful little girl (all 8lbs 9oz of her) with absolutely no tearing at all.  We did perineal massage (gentle stretching of the vajayjay with vitamin E oil) for about 2 months before we had her.  The supine position (on your back with your feet in the stirups) puts way more strain on the perineum... we had her in a sitting position, in 3 pushes... no drugs at all...
I feel so terrible that your doctor was like that with you.  My best suggestion would be to shop around until you find someone who will encourage you and be supportive through the process. and most importantly respect your mental and emotional health as much as integral parts of your physical health. A doula or labor attendant (someone other than you and your partner) could help too if you don't have a great OB, they can be a voice during hard labor, and if and when things get a little hairy.
Our first OB was horrible I'm very private about that area and questioned the necessity of some tests they wanted to do and the nurse replied "this is nothing, just wait till you see what they do to you when you have a baby"to that I quicky replied... well it doesn't take 50 people putting their hand in your vagina to have a baby... please leave and get me another nurse.... that aside we were relocated for the military and found amazing midwives who were super supportive of all of our wishes
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7494870_tn?1391329575
Just to jump in here on an old thread....
20 years ago I had my first child in CA. Epidural, manual stretching, no tear.
17 years ago I had my son in OK, 1 pound larger than his sister, epidural, episiotomy- HUGE 4th degree. That was painful to heal and took about 6 weeks.
Never healed right, same GP delivered my 2nd daughter, she was 2 pounds less than her brother.

I had ripped on top of the original episiotomy with her and now 16 years later suffer complications from that experience. Both visual and medical, to the point where I can feel the tearing each time I have had sex over the past 2 weeks. Up until now it was a slow process from flaps of skin that pulled from the poorly placed stitches, to leakage from my anus...but over the last few months the distance between my vagina and my anus have decreased to scary slivers of skin and ( i will double check with my OB next week) I am sure will require additional surgery to fix.

My advice. OB/midwife only. NO GP. My opinion is NEVER again. It is as archaic as laying on your back to deliver. So what if the doc has to spend a few extra minutes fixing a jagged edge of a maybe tear. I just do not see the overall advantages of the "standard" practice of cutting every woman who gives birth. Ridiculous.
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