Tearing Vs. Cutting

The idea of a routine episiotomies has been a real interest to me lately. I have a friend that had only paper cut tears during her two kids. If she had been cut during her delivery, she would have had to be sewn up and been in more pain just because ‘routine episiotomies’.

My sister-in-law and I were talking about episiotomies vs. natural tears after I wrote this post, so I decided to come back in and add a few comments that we talked about.

The major one in my head was always the idea of a piece of fabric. You won’t be able to tear it just by brute force strength. But if you make a small nick in the fabric and then tear it, you don’t need to exhert any strength at all. It rips right down the seam.

Since the world is turning more toward natural birth, though not a lot, a lot of people are coming out and asking their physicians point blank about their episiotomies. A lot are revising their views to be on a case by case basis, so routine episiotomies aren’t in fashion as much as they once were.

Episiotomies are done to keep a woman from getting 3rd or 4th degree tears, to stop urinary incontinance, and they are also done when forceps are needed.

The only thing with it stopping urinary incontinance is that you have already stretched before the baby crowns. An episiotomy is done on your perenium, not your birth canal. It just helps get the baby out faster to keep stretching at a minimum.

The negative sides to having an episiotomy are that you have a longer healing time, tears can actually get bigger (such as with the fabric above), increased pain when intercourse is resumed, and infection.

The good side about episiotomies are that they are a lot easier to stitch, they speed up the birth, and they can help keep vaginal tears to a minimum. Since it is a straight stitch, the doctors are able to find the pieces and fit them together faster so your time in the stirrups is lessened.

A lot of people say that your body will only tear enough to get the baby out. If it is a small baby, you will stretch to your limit, then tear. It all depends on if you prepared yourself during your pregnancy, and you use the positions that help to fan your perenium. Some people are naturally more elastic than others.

To prepare yourself to stretch during pregnancy, you can try doing the following things:

1. Adequate nutrition (healthy skin stretches more easily)
2. Kegel exercises during pregnancy
3. Discussing your concerns with your physician
4. Perineal massage during pregnancy
5. Controlled pushing, which allows more time for your tissues to stretch (you push very slowly. It takes longer, but your body stretches slowly so there aren’t any sudden movements to tear you faster)
6. Warm compresses during labor
7. Manual stretching by the physician/midwife during delivery

In the end, you can prepare all you want, and still have a 4th degree tear.

The one thing that is great about labor and delivery is that it isn’t the same for every person. It all comes down to doing what you are most comfortable with. If you are terrified of being cut, try doing it yourself. If you are terrified of tearing, have them cut you. The only person going through the labor is you, and only you can make it what you are most comfortable with. Your decision, no matter what it is, will empower you and you will feel great about your outcome.


One Response

  1. Thanks to you, I know spend a great deal of time obsessing over/reading about/talking about birth stuff! I love your blog. Keep it up!

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