Episiotomy question... please give me your input!

[hopfulEparents]

for those of you who have already had kids a have a question. Im really nervous about the idea of getting an episiotomy.  So, how common are they these days and is there anything that I could be doing now to avoid needing one or tearing?

[findinghumility]

According to my doctor and most research I have done, generally the natural tear is much easier on you. There is no way for the doctor to know how much you will tear and it is very possible his cutting you will be greater then what you would have done on your own.  Most women would not need an episiotomy to speed up delivery. My rule with my doc was DON"T CUT ME unless I start tearing up rather then back.  Also when you tear your body tears along natural muscle lines rather then a straight cut through muscle..I've been told that the natural tear will generally heal better.  I had an "average" tear with both of my boys.  I think mainly because they came so fast, my first was 6 pushes my second was 2 pushes.  Then there is a friend of mine who had an almost 11 pound baby, pushed for 3 hours and didn't tear at all.  

Like the previous poster mentioned I know midwives especially will to perineal message during labor and the pushing phase as well as general support of the area by putting pressure on it with their hands. They have much lower instances of tearing.  Also you can have your doctor or nurse coach you when pushing so you are giving yourself time to stretch.  I had a hard time with this as I went drug free for both of mine and when you have that urge to push it's very hard to hold back.  That being said even with a drug free birth you do NOT feel yourself tear as when you push the blood leaves the area and it's a natural numbing effect.  You could however feel the episiotomy if the doc does it when you are not pushing.  That would be terrible.

Good luck to you!  I worried a lot about that part of pushing too, but in the moment it's really the furthest thing from your mind.  You just have to make sure they know your wishes if you DON'T want one and trust them to do what is needed.  Good Luck!

[GRose]

I had to have an episiotomy, they had to cut VERY deep cause I was pushing for 2 hours and my sons head just kept going back inside.
I know OBs recommend that you massage your perenium during your pregnancy to stretch things out, although I really don't think this would have helped me since I had to be cut so deeply. I was happy they did an episiotomy instead of me tearing cause I was horrified of tearing from hole to hole.