Aa
Has anyone had a perineal laceration?
My husband and I are working on our birth plan, and we don’t know if we should allow my doctor to cut me during vaginal delivery if he decides that I could tear. I am seriously considering just letting myself tear or hope that the doctor is wrong if this would even become the case. I might be able to have a nice, smooth, natural birth. (You can all probably tell this will be my first delivery once you’ve read that description. haha)
Also if anyone has advice to help ensure a “smooth natural birth” you just let me have it. I want this more than anything. We are getting ready to begin our Lamaze classes, but I am really skeptical about the hospitals in my area. I called and asked simple questions about the hospital they work in & they couldn’t answer them. I asked the two hospitals that are closest to me “What percent of cesareans are performed there?” and “What classes are offered?” One of the responses to my last question was “We offer em’ all, the girl that teaches the classes does a combination of them.” My very next question for this was “Well, is this GIRL certified to teach them all?” I am telling you the honest to God truth… She said “NO.” Is that even legal?
Also if anyone has advice to help ensure a “smooth natural birth” you just let me have it. I want this more than anything. We are getting ready to begin our Lamaze classes, but I am really skeptical about the hospitals in my area. I called and asked simple questions about the hospital they work in & they couldn’t answer them. I asked the two hospitals that are closest to me “What percent of cesareans are performed there?” and “What classes are offered?” One of the responses to my last question was “We offer em’ all, the girl that teaches the classes does a combination of them.” My very next question for this was “Well, is this GIRL certified to teach them all?” I am telling you the honest to God truth… She said “NO.” Is that even legal?
(scared to comment)
But I have been reading all your comments... Thank you for sharing. hehe
Now we just all need to grab a bowl of pickled icecream, kick up our swollen feet, and relax. lol
LOTS OF LOVE,
mature_enough
But I have been reading all your comments... Thank you for sharing. hehe
Now we just all need to grab a bowl of pickled icecream, kick up our swollen feet, and relax. lol
LOTS OF LOVE,
mature_enough
Good - glad you are moving on. I hope you enjoy your episiotomy and have a birth that YOU are happy with. that is all that matters - that we are all individually satisfied with our choices and birth. What is good for you is definitely not good for me.
I would like to add something about the comment directed at me saying "I will do whatever my doctor says"... First off, this is my THIRD child... It's not my first rodeo! Second, as I "stated before" my opinions are based MOSTLY on MY PERSONAL experience, NOT literature... and finally, I never said I want a "medical birth" as you call it, based on THIS??? That's ridiculous to say someone is choosing to have a baby in a Hospital where there are trained professionals to care for them and their new baby based on the POSSIBILITY they MIGHT tear???? silly, just silly.... now im moving on... good luck!
lol... getting catty around here... and I still disagree and have read plenty of "studies" that contradict your "facts", as there usually are always studies designed to support an opposing idea/theory, but whatever you all decide for yourselves is great! moving on...
my hospital has a spa (jakuzzi ) to help smoth the labor, maybe in couple years water birth will be more popular and easy to find i heard it is less paintfull and verry popular in Poland even in smal towns theeits available
COMMUNITY LEADER
I havent read through all the comments so I hope im not stepping on any toes......... With all 3 of my previous delivery I had I only tore a little with my last (enough for 1 stich) My first 2 babies heads were huge (above the 75% at birth) and I didnt have any problems with tearing. My doctor now doesnt believe in doing episotomys so thats great for me:) With my first baby I had no idea what to expect. I had a great doctor though (he delivered DH) Anyways he used some kind of oil and massaged my opening as I was pushing to avoid tearing. Im not sure if thats why I didnt tear but he believed that it works. You could ask your doctor if thats an option. Unfortunatly no matter how prepared you are for labor and delivery, sometimes the unexpected happens and it becomes nessecery for an episotomy or even other medical interventions that you were hoping to aviod. As long as you go into it with an open mind you will be fine. As for as natrual as possible...........we you thinking drug free?? A little peice of advise on that since your wanting opinions. Dont labor in bed!! Thats just my opinion though. If you are laboring with out pain meds than move around as much as possible. Try a variety of postions to ease you pain. Walking, a ball, a tub. Laying in a bed only makes the pain worse because your not able to move about to ease your contractions. Besides if your not hooked up to moniters than there is no reason to be in bed anyways. Walking kicks in gravity. Good luck with everything! And keep an open mind. I personaly know I dont have to have an episotomy unless there is some kind of emergency where the baby is stuck or needs to get out quick. But with this being your first baby you never know what to expect. Good luck!!!
birth is so unique that we migght made up our minds on smth right know and everything might turn around when its happens:)
lke before i wasnt scared at all and i was no meds no nth, and now i am scared and i dont know anymore , i guess i watch to much births in tv:)
Good luck to all
lke before i wasnt scared at all and i was no meds no nth, and now i am scared and i dont know anymore , i guess i watch to much births in tv:)
Good luck to all
Well, I don't know about anyone else...but I'm definately going for the medical birth this time. I've had a baby with no medication and no episiotomy...and, incidentally, I did tear a bit, but not severely. However, I realized afterward that I didn't get any special medals. So, next time around I chose the epidural. Ended up being a blessing, as he was a large baby (big head and shoulders) and was stuck. I pushed for two hours and had to be cut twice to get him out. In my opinion, neither baby was better or worse off for my decisions. They were both healthy, happy babies. And both birth experiences were precious and beautiful and two of the happiest days of my life. And I healed both times. So, honestly, either way you choose to go will turn out great, I'm sure.
Tricia
Tricia
As long as we are both happy with our birth, that is what matters.
JAXX55 clearly wants a medical birth based on this and her past posts. I know she wants an epidural and will give birth in a hospital and listen to whatever her doctor says
I want a natural birth, with as little medical intervention AS POSSIBLE. Since I am pregnant this time with twins, who knows what is possible until the birth rolls around...I will do my best to make sure I have as little intervention as possible as long as no risks are posed to my girls. But I will 100% not be getting induced, or getting an epidural or episiotomy.
And for the record, when I post anything, I usually either 1) give my experience or wishes or opinions or 2) give facts that I got out of books or journals. I don't just pull it out of my a$$ and I dont like when someone implies that I do.
JAXX55 clearly wants a medical birth based on this and her past posts. I know she wants an epidural and will give birth in a hospital and listen to whatever her doctor says
I want a natural birth, with as little medical intervention AS POSSIBLE. Since I am pregnant this time with twins, who knows what is possible until the birth rolls around...I will do my best to make sure I have as little intervention as possible as long as no risks are posed to my girls. But I will 100% not be getting induced, or getting an epidural or episiotomy.
And for the record, when I post anything, I usually either 1) give my experience or wishes or opinions or 2) give facts that I got out of books or journals. I don't just pull it out of my a$$ and I dont like when someone implies that I do.
i gotta laugh...look at us all with our hormones. i think we've all ended up in one disagreement or another on here...i certainly have and got soooo worked up about it at the time lol.
In reference to your comment on blood loss, please allow me to let you know where I got my FACT from. A study investigating factors associated with post partum hemorrhage found that mediolateral episiotomy increased the risk of hemorrhage more than 450 percent and midline episiotomy by 33 percent. - Combs CA, Murphy El and Laros RK. Factors associated with postpartum hemorrhage with vaginal birth. Obstet Gynecol 1991; 77 (1):69-76.
You also stated that they are to prevent anal tears, but allow me to tell you where I have my facts. Another study , evaluating perineal outcomes in over 1250 women, found that women were over four times as likely to experience anal tears with an episiotomy. - Wilcox LS et al. Episiotomy and its role in the incidence of perineal lacerations in a maternity center and a tertiary hospital obstetric service. Am J Obstet Gynecol 1989; 160(5 Pt 1):1047-1052.
"studies consistently show strong associations between midline episiotomy and anal tears.... mediolateral episiotomies dont predispose to anal tears, but they do not prevent them either" - "The Thinking Woman's Guide to a Better Birth. Henri Goer.
No offense, but I dont care if you disagree with me. We are all entitled to have our own opinions and to inform ourselves to the degree we wish to. Some are well informed, some less, and some choose to blindly believe whatever their doctor tells them. You choose whatever you want to believe, but I stated facts.
You also stated that they are to prevent anal tears, but allow me to tell you where I have my facts. Another study , evaluating perineal outcomes in over 1250 women, found that women were over four times as likely to experience anal tears with an episiotomy. - Wilcox LS et al. Episiotomy and its role in the incidence of perineal lacerations in a maternity center and a tertiary hospital obstetric service. Am J Obstet Gynecol 1989; 160(5 Pt 1):1047-1052.
"studies consistently show strong associations between midline episiotomy and anal tears.... mediolateral episiotomies dont predispose to anal tears, but they do not prevent them either" - "The Thinking Woman's Guide to a Better Birth. Henri Goer.
No offense, but I dont care if you disagree with me. We are all entitled to have our own opinions and to inform ourselves to the degree we wish to. Some are well informed, some less, and some choose to blindly believe whatever their doctor tells them. You choose whatever you want to believe, but I stated facts.
I disagree with the "facts" pookie stated... there is no "factual" evidence that states epi's cause more blood loss than a tear would. Its common sense that if you tear in a random direction, it could go anywhere, as to where an epi is controlled and is designed to PREVENT the extra blood loss/pain/recovery...
its your decision in the long run... ask your doctor, im sure he'll agree with having an epi as being MUCH safer than tearing...
and epi's are designed to KEEP FROM tearing in the BUM... if you tear "back there" it will take FOREVER to heal and could cause problems that will last a LOT longer than an epi ever COULD... good luck!
its your decision in the long run... ask your doctor, im sure he'll agree with having an epi as being MUCH safer than tearing...
and epi's are designed to KEEP FROM tearing in the BUM... if you tear "back there" it will take FOREVER to heal and could cause problems that will last a LOT longer than an epi ever COULD... good luck!
YvetteY - I as not referring to anyone in particular - just a general comment.
You are right, there are 4 levels of tears, and an episiotomy makes a second level tear. But in addition, fact is that Episiotomies increase the number of women with perineal injuries, cause considerable pain, and increase blood loss
Other facts about episiotomies are:
- Episiotomies do not prevent tears into or through the anal sphincter.
- They do not cause less pain than do tears.
- Primarily, but not entirely because they predispose to anal tears,, episiotomies increase the risk of infection, delay healing.
- Episiotomies increase blood loss.
- Selective episiotomies do reduce perineal injury rates during instrumental vaginal deliveries (forceps or vacuum)
Mature-enough -
To protect your perineium - and hopefully not need an episiotomy or tear :
- do perineal masage (I live in Germany and here there is a special oil that you can buy for a perineal massage)
- do kegel exercises
- find doctor or midwife with a low episiotomy rate
- refuse a ROUTINE episiotomy
- avoid an epidural, as epidurals increase the odds of episiotomy and instrumental vaginal deliveries
- apply warm compresses to the perineum during birth (like I said, my midwife didnt just use warm water compresses, but warm coffee compresses)
- apply oil and massage during birth
Just make sure if you or your dr feel there is a need to get an episiotomy, make sure it is a good reason.
You are right, there are 4 levels of tears, and an episiotomy makes a second level tear. But in addition, fact is that Episiotomies increase the number of women with perineal injuries, cause considerable pain, and increase blood loss
Other facts about episiotomies are:
- Episiotomies do not prevent tears into or through the anal sphincter.
- They do not cause less pain than do tears.
- Primarily, but not entirely because they predispose to anal tears,, episiotomies increase the risk of infection, delay healing.
- Episiotomies increase blood loss.
- Selective episiotomies do reduce perineal injury rates during instrumental vaginal deliveries (forceps or vacuum)
Mature-enough -
To protect your perineium - and hopefully not need an episiotomy or tear :
- do perineal masage (I live in Germany and here there is a special oil that you can buy for a perineal massage)
- do kegel exercises
- find doctor or midwife with a low episiotomy rate
- refuse a ROUTINE episiotomy
- avoid an epidural, as epidurals increase the odds of episiotomy and instrumental vaginal deliveries
- apply warm compresses to the perineum during birth (like I said, my midwife didnt just use warm water compresses, but warm coffee compresses)
- apply oil and massage during birth
Just make sure if you or your dr feel there is a need to get an episiotomy, make sure it is a good reason.
thats a good post and verry helpfull. i havee one more question to you expierienced ladies . what oil should i use. and thanks again for all great advice
I assume you are talking about me....the information I gave about perineal tears was not an opinion. There are 4 different levels of teras and the 3rd and 4th level describe the sphincter and rectal tearing I told the post. And it is t certainly possible to completely rip the perineal area. This information I provided is in fact proven .....it doesn't always happen, but it's a risk. And you could be facing fecal incontience with that severe of a tear. This is the reason they started doing episiotimies in the first place.
There are a lot of studies that indicate that episomoties take longer to heal than tears.
We all have our own opinions about births and how we would want to have each aspect happen and that is fine because what matters is that each of us is satisfied with our birth.
(but keep in mind opinions don't equal facts....some people state their opinions as if they were proven facts.)
We all have our own opinions about births and how we would want to have each aspect happen and that is fine because what matters is that each of us is satisfied with our birth.
(but keep in mind opinions don't equal facts....some people state their opinions as if they were proven facts.)
Still keeping my options & my ears open... I want to thank you all for sharing. :) Anything else? Please add! (Just in case this does become a decision I have to make during childbirth... If not, I will be extremely thankful.) If this problem does arise, I will be even more appreciative to you awesome women, mothers, and grandmas for sharing your experiences, opinions, knowledge, and advice to reflect on my ultimate decision when the time comes. (Not too awfully long baby!) :D
By the way you don't have to be certified to teach prenatal classes. Some people have degrees and certification, but no it's not a legal requirement.
Are there really docs out there that would let you tear on your own? Unless you're seeing a midwife or something, who's all into being as natural as possible, it's pretty dangerous to tear. There's not a lot of room in the perineum. You could rip and it could go all the way to your rectum. The episitomy is more controlled. And you're healing time would be a whole hell of a lot longer. Do you even have a clue if you ripped how much that would hurt post partum. You'd probably be sitting on a donut for months. And if your tear went back as far as your rectum you could even risk the possibility of having to wear diapers yourself.
im the opposite - if he thinks I'll tear, i'd DEFINITELY take the eposiotomy over a tear. The reason why is b/c a tear could end up ALOT WORSE than the epi... you dont want it going farther down or sideways, etc etc... that could be a disaster! good luck with your decision...
If I may add my two cents....if the doctor's would allow the pressure of the baby's head to gently sit against the perineum, there is less chance of tearing. The pressure of the babys head just against that area, causes it to stretch gradually and naturally.
So many doctor's are in such a hurry to get you to push, as soon as they see the baby's head start to crown, that they don't allow for the natural stretching to occur. All that pushing to get the 'baby out faster,' for the sake of the doctor's, is what causes most tears.
The oil massage on the perineum is the best advice you have been given by others. If your DH will dip his finger tips into the oil, then slightly pinching and rubbing on the bottom part of the vagina, to the left and then to the right, then repeating several times, helps to stretch this area out. This is where you will usually tear when the baby is very large or the doctor's have you pushing like mad.
If you have a fast delivery of the head that happens naturally, there may be no way to prevent a tear. If you have used the oil on the perineum several weeks before delivery, this will be of tremendous help. At delivery you can also ask your doctor to oil and massage the perineum, as the baby's head starts to appear at the vaginal opening. Unless there is a need to get the baby out quickly, there is no need to rush delivery. Women weren't meant to push so hard that their babies would fly across the room if not caught by the doctor.
IF you need to have an episiotomy, you would much rather have the doctor make a "controlled" cut, then tear. I have seen my daughter tear all the way down to her rectum from a doctor trying to hurry the delivery. It took her a long time to heal and she was quite sore from the stitches. The doctor was an idiot....in this grandma's opinion.
All the responses you have received, give you great information.
Make sure you tell your doctor before delivery, about not wanting to rush the emergence of your baby's head, unless it's medically necessary to hurry the birth. Tell him you want the baby's head to do the stretching naturally. He'll know what you are talking about. Talk to him about his opinion of episiotomy's BEFORE you deliver.
Most of all....remember that you may not tear or need to be cut at all. Women have been having babies for centuries. And to this day, no one delivery, is the same as the next. Please don't worry.
Best of luck to you, your DH and your new baby to come....
Heather
55 year old Mother of two kids...one 8 pds. 7 ozs. and one 7 pds. 10 1/2 ozs.
I tore with the first baby because he came out so fast, with only one push. (I swear on my mother's grave, I am telling you the truth. One push.) They told me then I was built for having babies. "Good hips"
So many doctor's are in such a hurry to get you to push, as soon as they see the baby's head start to crown, that they don't allow for the natural stretching to occur. All that pushing to get the 'baby out faster,' for the sake of the doctor's, is what causes most tears.
The oil massage on the perineum is the best advice you have been given by others. If your DH will dip his finger tips into the oil, then slightly pinching and rubbing on the bottom part of the vagina, to the left and then to the right, then repeating several times, helps to stretch this area out. This is where you will usually tear when the baby is very large or the doctor's have you pushing like mad.
If you have a fast delivery of the head that happens naturally, there may be no way to prevent a tear. If you have used the oil on the perineum several weeks before delivery, this will be of tremendous help. At delivery you can also ask your doctor to oil and massage the perineum, as the baby's head starts to appear at the vaginal opening. Unless there is a need to get the baby out quickly, there is no need to rush delivery. Women weren't meant to push so hard that their babies would fly across the room if not caught by the doctor.
IF you need to have an episiotomy, you would much rather have the doctor make a "controlled" cut, then tear. I have seen my daughter tear all the way down to her rectum from a doctor trying to hurry the delivery. It took her a long time to heal and she was quite sore from the stitches. The doctor was an idiot....in this grandma's opinion.
All the responses you have received, give you great information.
Make sure you tell your doctor before delivery, about not wanting to rush the emergence of your baby's head, unless it's medically necessary to hurry the birth. Tell him you want the baby's head to do the stretching naturally. He'll know what you are talking about. Talk to him about his opinion of episiotomy's BEFORE you deliver.
Most of all....remember that you may not tear or need to be cut at all. Women have been having babies for centuries. And to this day, no one delivery, is the same as the next. Please don't worry.
Best of luck to you, your DH and your new baby to come....
Heather
55 year old Mother of two kids...one 8 pds. 7 ozs. and one 7 pds. 10 1/2 ozs.
I tore with the first baby because he came out so fast, with only one push. (I swear on my mother's grave, I am telling you the truth. One push.) They told me then I was built for having babies. "Good hips"
i had the cut. didn't even know! figured it out myself afterwards, they pretty much routinely cut if you're having a ventouse ( suction cap ) delivery. i did not feel a thing and i've had no problems since. on this plan, i've told them to do the cut if they need to, but not to tell me they are doing it because the thought freaks me out.
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