Episiotomy: A Vagina’s Lament
Hi, my name is Rebecca Woolf and I had an episiotomy. Oh and also? It sucked. An episiotomy for any of you breeders-to-be is when the doctor, cuts your vagina during delivery to make it easier to get the baby out or if you, prefer a diagram, this. Some episiotomies I’m sure are warranted. Mine, I believe, was not and I’d like to take this opportunity to speak against episiotomy-happy doctors and ask you, my dear readers some birth-after-episiotomy questions.
Still with me? Okay then….
A little back-story on my particular birth experience: My former OBGYN sucked all kinds of ass. Not literally, as far as I know, but I like to imagine him in compromising positions because the dude was a complete asshole. You can read more about that, here, if you so desire. As for now, I’d like to talk about the episiotomy he gave me even though I told him I absolutely didn’t want one. I pushed once, people (ONCE!!) before my doctor gave up on me and cut me to “get the baby out faster because it looks like you might tear…”
Once again, I was only pushing for two minutes before my doctor gave up and cut the shit out of my shit. No shit.
My episiotomy was not slight. It was severe and not only did it take me weeks before I could pee without crying, but it took me a year before I stopped itching my crotch. It was like a yeast-infection on speed as it was healing. Not fun at all. Not only that, but it STILL doesn’t feel the same down there. He cut through the muscle tissue so the whole vag-area feels just very funky and sad.
Needless to say, I’m now with another doctor. A GREAT doctor who knows my story and also knows that I really, REALLY REALLYREALLYREALLY don’t want another episiotomy, like, at all, but who also let me know that those that have had them before are more likely to tear pretty severely where the cut was previously made. This made me sad.
I realize the damage has been done but I REALLY don’t want another episiotomy and I’ve heard conficting reports about tearing being a faster heal than being cut with scissors. Doctors seem to typically state that “epsiotomies heal better than tears” except little tears vs large episiotomies? No way. I don’t buy it.
So enlighten me with your TMI stories, my fine female friends… Did you get an episiotomy during your first birth only to go on to have an episiotomy-free, (relatively) tear-free second birth or am I kidding myself with this dream of mine?
Share your VBAE* stories with me, will you?
(And for those mothers-to-be, please find a nice doctor who isn’t episiotomy-happy. If you’re giving birth in the LA area, I’m happy to supply you with the names of great OB’s who don’t suck. Knowledge is powah, bitches.)
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*episiotomy
I didn’t have one with either delivery. My first baby I pushed for nearly 3 hours. I ended up with 3rd degree tears and 46589999 stitches. Ouch. And yes I had the same experience you did with healing. The second time, he came out in 2 pushes and I had a minor tear. 2 or 3 stitches, very little pain during recover and was able to have sex again at 5 weeks no problem. I would recommend not having one for a second baby. I think you will be pleasantly surprised at how much faster, easier, and quicker the delivery and recovery are the second time.
Shannon makes a good point – it’s common for the subsequent births to require less pushing. Apparently things are a little more.. er… stretched. Or more easily stretched. Whatever.
Also, have you looked into ways to help with the.. um… stretching? I know for me, the epidural loosened everything up. As did copious amounts of perineum massage and sitting on The Ball with the second one (which I didn’t do with the first).
I had one with the oldest, but not with the second one three years later. I really didn’t want one, but they said I was too small to get my 8.5 lb baby out without one. The second baby was slightly larger (8.7) but apparently the first childbirth had stretched me out, cause she also came faster (which supposedly increases your chances of having and epi) and yet, I was fine. Healed a lot faster, too…with less pain. Second babies teach us so much! Good luck!
Okay, this won’t answer your question, but I have to use this forum to brag about my husband. While I was in the pushing stage of giving birth to my second, the doctor decided she wanted to give me an episiotomy. She was worried that the baby might need to come out faster, blah, blah, and blah. I was quite out of it and not in the mood to argue with anyone. I actually didn’t want to speak at all. My husband, however, never quite loses the urge to lay the smack down. There he is, standing right next to the doctor in front of my gaping hoo-ha, questioning her research and reasoning. Back and forth. She thrusted, he parried. My glazed gaze was working overtime to keep focus. In the end, he won. She didn’t do the episiotomy. I got a second degree tear, but it really wasn’t that bad and it healed easily.
I’m really proud of him. Too bad that after the adversarial tone of his interactions with the doc, he didn’t quite feel justified in asking her to “put in an extra stitch” for him
My first two deliveries were at university hospitals, while my husband was in his residency. The doctors there did episiotomies – they also turned off epidurals for first-timers, so that they could “feel” to push. They didn’t advertise this, of course. I didn’t have much pain after the first delivery, but I did after my second. It was so depressing to have to sit on my very painful parts every two hours and nurse.
My third baby was born in a private practice hospital – my OB, a woman, did some perineal stretching, and said that I wouldn’t need an epis. The stretching didn’t bother me – I had an epidural. I wonder if female OBs are more sensitive about the effects of episiotomies. I had no problems afterward – it was great. Except that she screwed up my son’s circumcism, and we had to have it redone by a urologist a year later. Yes – out of three boys, we’ve had two circs redone by urologists.
My first child was 9.11, my second 9.4. My second was a planned c-section because delivering the first was such a nightmare. I am NOT big enough down there to drive a VW Bus thru, which is what my daughter felt like. I pushed for 3 hours with no progress, her head was corked like a bottle. They tried the vacuum (Nice, pointed head for a week) and then dislocated her shoulder to get her out. 13 stitches that I felt for about 3 years. Seriously, it hurt to sit up straight with my weight on my perineum for almost 3 years, total BS. I was perfectly OK with a section for #2.
No personal experience, thank god, but have always, always heard that tears heal faster than cuts… the ragged edges make it easier for the skin to form back together (makes sense, it’s more “natural” in terms of how the healing process developed in us). Also, to my knowledge, midwives/ doulas don’t do episiotomies, and I trust them a lot more than doctors with regard to birthing (sorry to all the good doctors out there). I have heard that if you apply warm pressure, like a warm damp washcloth, to the perineum and massage it when the baby’s head is trying to come out, it will help prevent tearing? again, no personal knowledge, just trying to help
i had an episiotomy the first time around with my 7lb. 11 oz. girl. then with my 9lb. 5 oz. boy i was episiotomy free! a midwife delivered in a hospital (midwives are the Army’s preferred baby deliverers)
she took her time and massaged the area when he was crowning. she ran her fingers around and under the rim. she manually stretched me out. i must admit that it hurt like HELL when she got to the top part (still makes me cringe at the thought!!) but it is very possible. i had no issues after whatsoever. after the episiotomy though i cried everytime i sneezed- i never knew i used my vag to sneeze!!
good luck to you- it is possible!!!!
Hi-I actually haven’t had an episiotomy. I was so scared of hospitals I opted for a birth center and homebirth for Nos. 1&3. #2 was born in a hospital and was csection. No fun either. I’ve recently learned through my midwife that many doctors do not properly stitch after episiotomies and that is what causes the majority of the problems post-partum (like the ones you mentioned). And actually, a second birth with a doctor who stitches well can make you feel like yourself again. A second birth that is allowed to tear, if necessary, can reopen those scars and then be stiched correctly to erase the long term issues from before. I was quite shocked as she told stories of watching doctors stitch for a little bit and then be finished, only to leave the mother still hanging open in areas.
Also, perineal massage and perineal pressure during pushing the second time will reduce the likelihood of a tear. The best thing to avoid tearing is actually not to push at all, but to let your body do the work. The pushing done, while the nurses count and tell you when to breath and exhale, is actually a horrible thing to do to your bottom. You are doing the best thing for yourself by gathering as much info as possible. Good luck! Can’t wait to hear how it all goes!
With my first baby, I tore very badly and had to get (seemingly) hundreds of stitches. It took at least 45 minutes to sew up, that’s all I know — I didn’t actually want a stitch count. Anyway, for my next two children I used this device called an epi-no (you can check them out at epi-no.com). It’s a balloon-type device that you use to gently stretch yourself in the two weeks leading up to your due-date. You can’t buy them in the US, but you can get them on German eBay. They’re totally worth it — I haven’t torn since I started using it, and I am a very small person (5’3″) have really big babies (between 9 and 9.5 pounds each). I highly recommend the epi-no to everyone!
You guys are awesome. Great recommendations. Birth ball is a great call and perineum massage is key for sure. Archer wasn’t a huge baby and the doc knew he wouldn’t be (I was induced several days before my due date and Arch was 7 pounds) and I’m 5’8 with childbearing hips fo sho so I feel cheated out of something I feel like I could have done without intervention. I’m definitely preferring tearing at this point and thank you, Sarah for your comment about the possibility my doc sewed me badly — that gives me hope for the next time even if I do tear…
Oh and Lara? Archer was circumcised by the same (dickhead) OB and he performed Archer’s circ wrong as well — We didn’t have it redone because I couldn’t deal and if we were having a boy this time around? We would have probably opted against circ… which would have been a very catch-22 for us because Archer was circumcised and it would be strange (to me) to have one circumcised and the other not. This was my MAIN relief we were having a girl. Not having to deal with the circumcision decision.
It’s amazing how different the second time around is… for everything in life, I suppose.
I’m a tall girl (5’9″) and had an average size baby (7lbs 8oz.). I pushed for 2 hours and right when they said, oh we should consider an episiotomy, my son literally launched out–no head out first then pause, just his whole body at once–with the next push. I had a 3rd degree tear and had to be stitched back together. I have no episiotomy experience to compare it to, but it sucked pretty bad. Recovery was tough and I’m still feeling it 8 months later–sex hurts, tampons are uncomfortable, etc. Looking back, if I knew the outcome, I would have told the OB to go for the epi so that at least the damage could be controlled. You need to do what feels right for you, but you shouldn’t get the impression that tearing is necessarily the easier route.
My sister had a large baby without an epis, and the tears… they went thru her anus. She was so not right that two and a half years later, her doctor recommended a c-section because of the very real risk that she’d rip like that again and have to have a colostomy.
I also had a big baby, no epis, no epidural either. I tore pretty badly, 3rd degree, many stitches. It took me about a year and a half to quit being perpetually sore down there, and I’m not so sure I was sewn up right — it seems like some tissue is in the wrong place, like something that should be inside is now outside.
So, FWIW, tears and the repair work can be just as bad as an epis.
Enough TMI?
Good to know, RKG. Thanks for sharing.
I have had both tearing and an epi. With my first, she was 6lb 9oz I tore just about from end to end. It was quite painful and a rough recovery for me. My second, 9lbs 6oz, I had an epi and healed much quicker and wasn’t in as much pain. My last two, 8lbs 5oz & 8lbs 1oz, not even a scratch. They literally fell out!
tears heal faster than cuts. there is a reason doctors debride lacerations before suturing them back together.
(i work an in animal hospital so i’ve seen it happen a million times.) labouring in an upright position or in water also can help, not sure if either of those are options though, since you’re birthing in a hospital, but they might be. you might also want to try perineal compresses as well–believe it or not i’ve heard great things about warm olive oil. 
oh, and good for you guys on the circ decision, even if it’s not relevant for this baby. way to go!
I didn’t have an episiotomy but I really, really, really (!) recommend something called the ‘walking epidural.’ It’s a lesser / partial epidural that helps with the pain but still allows you to walk and also feel to push, so there’s way less chance of any tearing or an episiotomy. Walking epidurals are predominant here in Europe with good results, but I rarely hear about them from US women. I know you *can* get them in the US though. If I were you I would ask my OB about it now and get one lined up. I was able to kneel up to push and thus no damage, whereas if you have a regular epidural and end up lying down you often end up in trouble and then on comes the episiotomy…
Fucking ouch Rebecca Girl’s Gone Child. Damn.
I have never had a baby, but I am always shocked by my friends’ birth stories, and how horrifying some of them are. There is a great book called “Birth in Four Cultures” that discusses how things are done in places other than the U.S. Episiotomies are almost unheard of in places like the Yucatan, where *crazy alert* childbirth is not treated like a pathology, but like a perfectly natural biological act, and the mother’s body is allowed to dictate labor, and women labor while sitting in a hammock, upright. Gravity helps things along, the midwives massage, and everything gets stretched out gradually.
My first baby was 4 pounds 13 ounces and I had an episiotomy, my second baby was 8 pounds 9 ounces and I didn’t have an episiotomy and only a slight minor tear that didn’t require stiches. My first was delivered by a dr who was with me about 3 minutes, my second by a midwife only who did a great job making sure everything was ok with the vag. Both hurt a little to heal, but the slight tear healed much quicker. In the end I think you need to trust whoever is delivering baby to inform you if they think all systems are a go for stetching themselves.
One thing to consider is that induction can lead to labour progressing more quickly than the body is prepared for, so tears can happen more frequently and be more severe.
(Also…Thanks so much for your ‘bareness’ in sharing your life in beautifully constructed vignettes. I have been reading for some years (through all your archives both here and Girl’s Gone Child) and your clarity, even sometimes in the midst of confusion, is breathtaking.)
First, your DR sounds like my first OB only SHE was an ass. Fortunately for me at 36 weeks I had enough and switched. My new OB knew I didn’t want an epi so when I hit about 7/8 cms she had her nurse and/or my doula start “stretching” me out. I had no drugs so everything hurt and I didn’t notice. I did tear and required 10 stiches. However, on my following two children I did not tear even a tiny bit and never needed and epi. Course the nurse was massaging away to loosen me up. Sort of like clay, the more you work it the more pliable it becomes! I’d ask your DR about it and also talk to the nurse when admitted and tell her your concerns. I think you can do it without tearing if you’re “warmed up”, KWIM?
I, too, had an episiotomy with my first. Just now pregnant with my second, so haven’t any follow-up experience (yet). All I know, is I pushed for almost an hour and a half and my doctor gently advised an epi. I told him I wanted to keep trying, at least a few more pushes, before he got out the scissors. My baby was above average size (8’4) and I eventually did get an epi and out she came a handful of pushes later. I didn’t even know it was happening. He stitched me up while I looked at my baby. I had absolutely no pain. None. I had heard so many horror hoo-ha stories that I was amazed at my experience. All this to say, I really think it had to do with my doctor. I totally trusted his judgement and expertise and he did an awesome job. It’s all about having a doctor you can trust in the most difficult of moments. He allowed me to continue trying on my own, respected my wishes, and didn’t press, but gently advised. When it came down to getting the baby out, he knew what he was doing. I think you’ll be much happier this time around, just having a doctor you like. Good luck!
I had a second degree tear with my son. I spent a large part of the coherent portions of my labor babbling about not wanting to be cut, to the extent that my big Jamaican doctor man came up to me with a huge bottle of mineral oil and told me how he’d be massaging the area and I felt like I was in a really awesome porno.
I ended up only pushing about three times. I believe they would have slowed me down and helped the whole Not Tearing thing, but the baby’s heartrate was dropping with every push so they just let me go buck wild.
My junk definitely took more than a year to feel vaguely normal again, and the healing did suck a whole bunch. That little squirty water bottle was my friend for months.
You know about Tucks pads, right?
Anyway, I agree with all that said that your birth canal will be all nice and stretched out, so there will be much less pushing. At least that was my experience, and I did have a minor episiotomy the first time, but didn’t need one the second time around. I predict that Little Miss Thing will slide right out! And permit me to add that you are the HAWTEST 5’8 mom pregnant mom with childbearing hips evah!
No episitomies here. I tore a teeny tiny bit with my first baby… and the doctor gave me like ONE stitch (I guess he was bored after the delivery and wanted to feel like he’d done something to earn his money!).
Second baby, no tear, no nothin’. (Second babies, or at least their deliveries, are a walk in the park compared with the first ones! yay for second babies!)
Wishing you an episiotomy-free delivery this time!!
I know all about this one- and have strong opinions! I have three kids- our new little girl just two weeks old now- after a 13 year hiatus- wow. First child: pitocin, crazy intense labor, episiotomy, couldnt take a poo for weeks without giving myself an enema… couldnt laugh, walk, you know the deal. not fun. My second son, I was so terrified from my first experience that I stayed at home all through labor, taking it nice and easy. I barely made it to the hospital in time, but no drugs, no cutting, and a very manageable labor. I was up and about, laughing, eating, SITTING and taking nice healthy poos within hours of delivery.
With our new baby we had some concerns over her well being, and I wasnt tied to a drug free experience this time around (herniated disc… ugh) although was adamant about the episiotomy. Ended up having pitocin again, intense labor, but no cutting me up. Another beautiful recovery- what an easy way to make a labor experience more beautiful!!!
Stick to your guns mama.
From what I’ve read there are more and more doctors subscribing to the “tears heal faster than cuts” thing. The other thing that was explained to me is that you are more likely to tear beyond the episiotomy than if you don’t. Like a piece of fabric is more likely to tear if it already has a little cut in it. I guess it’s common for episiotomies to turn into really terrible tears. (Hope that made a tiny bit of sense.)
For me, personally: I had tearing. I had no episiotomy (even though the doc I go to was my mom’s doc and he did give her an episiotomy “back in the day” when I was born 26 years ago). I had 25 minutes of stitching which was pretty terrible. The stitching was worse than the pushing. I only pushed for 20 minutes. That being said, I healed perfectly fine. Sex after 5 weeks. No hurting/pain/other complications like it sounds like you’ve had. There was no crying during bathroom trips even the day after delivery. I’m with you, completely, on the no episiotomies thing.
I only have one DD so I don’t have a VBAE story but wanted to chime in just the same to say: stick with what you want to do…and trust that your new doc will honor your wishes…and awful tearing (that at the time didn’t even hurt and I didn’t even know I had torn) can heal just fine. Good luck!
I was concerned about episiotomy since my OB is in a large academic medical center that is inclined toward medical intervention at the drop of a hat. But when I asked her about it, she said they don’t usually do them unless it looks like an emergency, because her practice’s belief was that an ep often caused more tearing than would happen naturally.
Here’s how she described it: If you take a piece of cloth and try to tear it with your bare hands, it’s hard to do. But if you put a little snip in the fabric first, it’s easy to tear it all the way through.
Anyway, I delivered an 8-pounder and then a 9-pounder, both times with some minor tearing that healed up pretty quickly (although I did need stiches the first time).
I had hours of pushing with my first, and no tears; just a “trackmark” they called it. And I one-hundred-percent believe that this was because of the midwife, who used hot compresses and olive oil to ease me open; I was pushing as hard as I f*in could because I wanted to be DONE but she was looking out for the bajingo.
Six months later, I thank her
I pray that your second birth will be better– on you and down there. I recommend olive oil– get your husband down there! Or hire a doula.
Birth is such a big damn deal, any way you have it; I guess that’s why we can’t stop talking about it.
I never though of the fabric analogy before but that makes total sense… I wonder if my epi lead to tearing without my knowing… Hot compresses, olive oil and my husband in his “midwife” monogrammed t-shirt will be put to work fo sho. I’m also thinking a “birthing ball” is a good idea for loosening the situation beforehand. I was induced with Archer pre-due date (because of my Pre-E) so everything went really fast. I’m hoping this time around to go into labor naturally so I can work my body a little bit before the birth.
You guys are so awesome. I just adore all of you for your openness… I really believe this is stuff we should be sharing, discussing and talking about. The messy stuff is the most important to be aware of and many women aren’t. I know I wasn’t going into my first birth… so thank you all.
GGC – Just read your comment about hoping to go into labor naturally this time…yeah. Be prepared to not have as much time as you think to get “things” ready.
My first baby was two months pre-mature, no meds during labor, but second degree tear during delivery – from a 4 pound baby! Come on, right?!?! Well, the thing is, I know when it happened. The doctor said, “one more push and this baby’s out!” So I pushed…without a contraction, which shot his little body out and tore mine up. The things we don’t know the first time – push with contractions ONLY! The Dr. had been doing massage down there and all, but I was too eager, I guess.
So, in February with my daughter, I woke up at 4:20am with contractions 5 min apart, water broke at home at 5:20, at the hospital at 5:55, checked in at 6cm dilated, 9 cm at 6:30am, pushed for about 20 minutes and she was born at 6:53am. OH – and the Doctor wasn’t there for the delivery! The NURSE coached me beautifully, held warm, almost hot, wash clothes to my crotch and massaged, told me what was happening, let me listen to my body and helping me get my little girl out. It was beautiful. In the end, I had a small tear that required about 5 stitches from the Dr. when she arrived. (and I got a full bill from her office for the delivery! NO WAY am I letting that happen!)
My whole thought is that Dr.’s tend to make things easier on themselves, like cutting to get babies out. Oh, and I actually had a Dr. say to me, “Well, it’s just easier to stitch an epi that to stitch a tear.” I looked at him and said, “If you dare come near me with scissors, I’ll kick you in the head!” He ended up not being my Dr. for long.
Too long of a comment, but trust the Dr. you have. Trust your body, and kick them in the head if they want to do something you don’t want them to do!
With my first child my husband and I took the recommended birthing classes. One class in particular that I remembered was about the difficulties that could occur. This session involved the topics of vacuum, forceps, and episiotomy. Basically in the event that anything could go wrong these devices and/or procedures would have to be used. What I heard was in the RARE OFF CHANCE these things would have to be used, not all at once. Guess what, I had all three used on my first delivery, the episiotomy being the last straw, my son was 10 pounds and the cord was wrapped around his neck. I have to say the medical team that was assigned to me tried everything. I was in labor for hours! I will never forget being cut and the maniacal cry that came out of me. I could not sit or use the bathroom properly without pain for weeks, I cried and swore often. Although I think it was necessary to have the episiotomy the shock and the after care impeded my ability to bond with my son initially.
Two years later I delivered my daughter with no tearing and no utensils and she was 9 pounds. I think I was fortunate to have a doctor that really believed in doing everything possible before taking more extreme measures.
Good luck on your journey!
I had two drug free births with no episiotomies. I did have tearing both times. The tearing with the second one was a bit worse than the first although I can’t be specific with degrees or number of stitches as the doctors didn’t volunteer that info and I didn’t really care. I was healed within a week with the first and the second one was maybe a week and a half. I am not sure if the tearing was worse with the second one as I had torn before and thus it made retearing the tissue more likely or if it was the fact that the second one was a bigger, fatter baby. Probably a combo of both. Since I never had an episiotomy I can’t compare, but the natural tearing and the healing doesn’t sound any where near as bad as an episiotomy.
I haven’t had a second (and after pre-e here, you are my hero for doing it again… I have major fears about bad shit happening again and ending up in the hospital repeatedly and the emergency rush to the hospital to deliver a baby to save my life).
I wanted to share that I was induced too because of pre-e and my epidural didn’t work great, so I felt everything while I was pushing. I only pushed three times and the 6 lb nugget shot right out.
My doctor (who I credit for holding out, waiting for the posterior baby to make his slow progress, not freaking out when we had late decels and my BP was going up and up… all on a night that was the holiday party for the hospital OB/GYN staff… and I didn’t end up with a c-section), tried to slow me down and stretch things out, but after 26 hours of induced labor and six weeks of bedrest I wasn’t in to being calm and waiting for the perineum to stretch. Also, my epidural was so useless that I could NOT RESIST THE URGE TO PUSH and push I did.
Three minor tears and a medium tear for a tiny little baby.
Healing was pretty brutal, but I think it was way better than a cut.
Good luck and like I said, you are my hero for post-pre-e gestating.
That sucks that your last OB/GYN didn’t give you much of a chance. Who gets a baby out in ONE push?!?! Wonderwoman maybe
I didn’t have an epi ever with any of the three, and I refused the stitches too. I didn’t really tear that once but I had a slight laceration that the doctor applied some pressure on until it quit bleeding.
Here’s some info that I looked up when I wanted to absolutely avoid having an episiotomy as an option!
# Pay attention to your position during labor. You may feel more comfortable sitting upright, lying on your side, or getting down on your hands and knees, for example, instead of lying on a bed with your feet in stirrups. Different positions may put less pressure on your perineum.
# Avoid having anyone push down on your belly in an effort to speed up delivery. To keep from tearing, your perineum needs to stretch slowly and gently.
# Instead of pushing hard when a birthing coach tells you to, push with steady pressure when your body tells you to.
# Have someone provide perineal support, which means pushing against the perineum to protect it from tearing as the baby’s head stretches it. This is sometimes done with a hot, moist cloth.
# Do regular Kegel exercises in the months before childbirth. These can strengthen your pelvic muscles.
# Practice perineal massage, which makes the tissue around the vagina more flexible. Some studies show that women who massage this area daily during the last part of their pregnancy are less likely to have tearing.
Eeesh! I’ve had two babies in the past two years. With my son, I tore, HORRIBLY, on the side and to the back door. I can still hear the doctor saying, “Sutures! I need lots of sutures.” It took forever to heal. Every time I pooped, it was horrendous! Then when my daughter was born, almost 11 months later, episiotomy city. I read read read about it, and found it very hard to believe that a tear could be “better” than a cut. I kept comparing it to paper…tear vs. cut…In the end, I didn’t have the choice. The doc did an episiotomy, and it was much easier in my case. Less painful, quicker healing. Still makes me cringe! Good luck, Girl!
Hi Rebecca,
When jack was born, I had to make the decision alone about circumcision (My husband Garth had taken off to run some errands and I apparently HAD TO MAKE A DECISION RIGHT NOW! I figured that we would have him circumcised to match dad. They were going to take him have the surgery and I insisted that I get to go and comfort him. I had thought that Garth would be doing this, but he wasn’t around. We’re in the little area and Jack is two days old and pretty happy hanging out on the table, ready to go. Then they say I need some special socks (?) and that some nurse would stand in for me and I hit the ceiling. All before any scalpel had been drawn. I fling her out of the way, they shod me like a horse and I let Jack suck on my finger the whole time. He let out a little cry at the beginning, but once he got my finger he looked in my eyes and he was ok the rest of the time. The surgeon (a woman) did a beautiful job (thankfully). It was scary and I don’t think I’d do it again. Like you, our second is a girl (Collette), and that was one of the second things I was thankful for.
The doctor cut me with my first child, though as it turns out my daughter’s head was a good 2″ bigger than the “average” for newborns – a whopping 15″. I had about 40 stitches and was MISERABLE for about two weeks, though didn’t experience the itching you did (uh, can you say, WTF?).
I didn’t have an episiotomy with my second delivery and though he weighed almost half a pound more than my daughter, his head was only 14″. Tiny, 1/4″ tear, no stitches, healing was much faster.
(both kids were around the 9-lb mark, I grow ‘em pretty big apparently)
I don’t really feel like anything is different vag wise though – sort of sucks that your experience was so bad. Maybe you won’t need one this time? Or you know, kick the doc in the head when he wants to cut? ;o)
I just wanted to say “ditto” to the 6 points that Heather posted above–she hit the nail on the head. Point #1 about positioning is so important, as the current typical hospital position of flat-on-back-feet-in-stirrups is actually one of the worst positions anatomically for giving birth and is almost guaranteed to cause tears. Squatting (or squatting on an appropriately named birthing stool) works so much better. You can muster more strength to push in this position, too.
Point #3 is important to; steady pressure and gradually stretching the perineum helps so much. Massages with oil are a big help, too; don’t forget it’s a muscle like any other, so just treat it that way!
I know from your book that you gave up on the research with your first pregnancy, but I highly recommend some books (or websites/blogs) about natural birth because they are so FULL of helpful (and experienced) advice that can really make a big difference.
-Anja
I didn’t have an episiotomy so I am totally unqualified for this discussion, but I want you to know that just reading the comments is making my vagina hurt.
Fear not. I have delivered plenty of babies for Moms who has episiotomies the first time around (not from me!). Sometimes the previous scar opens up a little, but not always and NEVER as bad as the first time, with the right doctor or midwife. Good luck!!
I was adamant with both pregnancies that I did NOT want an episiotomy and would prefer to tear. I typed it up in my birthplan. It’s about the only thing that actually happened as I wanted either time. I don’t remember even having any problems after my first tot was born and the second time was not bad either. Maybe it’s the lack of sleep that causes post-baby amnesia though.
Best of Luck!
I had one small tear with my little guy. One stitch.
Just wanted to say that your idea about the birthing ball is a good one, in my opinion. Use it early and often. I was on mine almost every night for a little bit in the last weeks of my pregnancy. It takes the pressure off those widening, aching hips and I think it helped me get my body ready for labor.
Here’s the deal. I have had two drug free births. First one with an episiotomy AND then forceps to get her out and the second with tearing and pushing him out without any help. My daughter (1st) was 9 lbs. 6 ozs. and my son (2nd) was 8lbs. 2ozs.
I pushed for FIVE hours at home with a midwife (I’m convinced now she didn’t really know that much) with my daughter and she wouldn’t budge. I was an emergency transport to the hospital (30 minutes away) and once the doc got there, he tried everything because I refused a c-section. He tried the vaccuum thingy (joke) and then gave me the big E (episiotomy…not Ecstasy) to see if I could push her out. Didn’t happen, so he had to use forceps on me which hurt like a muthascratcher due to the big E. I don’t recommend any of this.
This last summer while pregnant with my son, I was convinced to have it go my way. I went to prenatal yoga and had a doula (Rebecca, you should look into this). My doula recommended perineum massages nightly with almond oil to help with the strectching. I made my husband do this nightly. I had a birthing ball and I studied Hypnobirthing. I labored at home with my doula and my husband until my water broke. My midwife met us at the hospital. My doula brought a crockpot with washcloths and we filled it with a ginger mixture that we used to apply to my downtown that was supposed to help decrease the chance of tearing. (Email me if you want the recipe!) I pushed for two hours in various positions and my son finally came out. I did tear somewhat, but I had a huge E scar and I don’t think I tore as bad as it could have been.
Good luck with everything!
P.S. I switched doctors three times before I found my midwife that I loved. That is power as well.
This totally doesn’t apply to me because I ended up with a c-section, but just to tell you what my doctor said when I was asking her about episiotomies before Pumpkinpie’s birth (because I was a smidge terrified). She said typically, allowing the birth to go slowly and maybe assisting in the form of perineal massage can really minimize tearing, and in some cases tearing can be little more than abrasions. She also said that yes, tearing is typically better in terms of healing, as it is often smaller or a couple of small ones, rather than something going right through lots of tissue. Good lukck with this, Beck.
I tore, after 15 hours of labor, and had a really long healing process and still don’t feel like all is in working order downtown. So, I’m not sure either option is awesome. My doctor laughed (Sadistic no?) while stitching me up and noted, apparently for all the spectators in the room, that my tear looked like the batman symbol. ha! isn’t that oh so funny?! anyway, good luck girl. way to speak up for want you want. it’s your body so be firm and confident.
Oh! I had a HORRIBLE episiotomy with my first. He was a forceps birth after a VERY LONG labour. I had been with midwives (otherwise he probably would have been a c-section). It was awful. No details, but had open wounds cauterized more then 6 months later. LOTS of stitches (so many, they wouldn’t tell me the number).
Fast forward to second birth. (Born at home, by the way). No episiotomy. The lovely midwives kept him in a bit longer (I pushed only about 15 minutes anyway) to keep me from tearing. In the end? SLIGHT tears – 4 single stitches that were just precautionary. I was up and walking around within the hour.
Hope that helps!
I have had four children. The first was my biggest, I had an episiotomy AND I tore! All kinds of fun. Had episiotomies for the next two babies, but healed quickly and felt better after each child. I did Not have an episiotomy for the fourth, but he was a very, very, very quick birth and I tore through and old scar. That being said, I healed the quickest and easiest after the fourth baby (tear only). I think the most important thing is that you are happy with your decision and your doctor. Our bodies sometimes do crazy things and if you’ve done all you can to make things go the right way, then there are no regrets!
Touche, Kris. You guys are so awesome. Thank you all for your encouragement and stories! This has been SO HELPFUL!!!
It is true that an episiotomy can cause you to tear. Doctors want to do them b/c they want to control it. This is your birth experience, not theirs and you should dictate what you want to them, not the other way around!
I was fortunate to NOT have an episiotomy and I barely tore. My ob referred to it as a skidmark! And after 50 hours of labor, I pushed for barely 40 minutes so he came out pretty quickly. I went natural and no agenda was pushed on me whatsoever!
My husband and I attempted the perineam massages, but I have to say it was quite uncomfortable– not anything like foreplay pleasure! I had a mantra during pregnancy, “open like a flower….” We did bring a bottle of olive oil to the birth and my ob did some stretching as I pushed. She also had me sit through a few contractions to let his head stretch me (not easy b/c you instinctually want to push and you feel the “ring of fire” and it BURNS)!
I had a birth plan two pages long. My doula made me minimize it greatly to less than one page otherwise the nurses would disregard it. That was very helpful. Some things need to be noted, some don’t!
Trust your body. You’ll do fine. Visualize what you want and find yourself a mantra. Talk to your little girl about working together to get her out.
All 3 of my boys were born with help from midwives. With my first two guys I was in labor for about 6 hours each, and pushed for about 15 minutes. These two (9lbs 2oz, and 9lb 7oz) required epis (and about 3 stitches each time). Man, I was sore for weeks.
My third boy weighed the least (8lb 14oz), but had a 15″ head! Yikes! I literally pushed for two minutes, though, and there he was. But no cuts, no tears and a beautiful, easy recovery. I used a different midwifery practice this time, and delivered on my side, as opposed to sitting up with the first two. By the way, totally HATED the birthing ball.
Until the little guy was born (3 months ago), I thought the soreness was a typical part of a vaginal delivery. It’s only now I realize it was the cut and stitches.
As for the circ question–I had the first two cut (now 6 y/o and 4 y/o), but not the baby. Like you, I had problems with doing this–on the one hand, I really didn’t want to have the circ done, but on the other hand, now he wouldn’t look like his dad and brothers.
Someone told me something to the effect of “When are they all going to be standing around comparing penises anyway?” Let me tell you: The first time my 6 y/o saw me change the baby’s diaper he asked, “Why is his peepers all pointy and mine is round?”
I had my girl 11 days ago. She was 9 pounds, 1 ounce, but I delivered at a midwifery center, so an episiotomy was never even mentioned. Also, despite not having an epidural, I didn’t feel my second-degree tear happening in the least. It hurt afterward, absolutely, but a donut pillow did the trick for the five or so days it took to stop aching. After several stitches and fewer than two weeks, I’m completely healed. So here’s another vote for risking a tear!
Wow, there are some stories here.
I was probably a candidate for an E. I had the raw pleasure of tearing in a “C,” a second degree tear. I lost a lot of blood and gained a lot of stitches. As my OB put it, “Labor wasn’t good to you.”
DERMAPLAST was my friend, that and a squeeze bottle of warm water. Recovery was horrible.
My son was 9 lbs. 10 oz. I was given an episiotomy – I don’t actually remember getting it, but my husband told me later that they cut me from one end to the other. The stitching was done and I spent the next year having pain with sex, tampons, sneezing…the whole deal. I finally went to a new doctor who redid my episiotomy…removed some scar tissue and restiched. I’ve been happy ever since with NO problems. I’m now pregnant with my second and SERIOUSLY considering c-section just so I don’t have to go through that again…somehow I imagine stiches across your belly as easier to deal with then stiches down below. Call me crazy!
With my first child I had an episiotomy and my doctor didn’t even ask me whether I wanted one or not, because she considered them routine – but I healed very well within about 6 weeks – fast forward 3 years to my delivery with my 2nd child, I had a hospital birth with a midwife this time and they did not do routine epis. so they decided to see how things went, well my son was 9lb, 3oz and I tore really badly, they told me it was a 2nd deg. tear but I think it was more like 4th deg. it took forever until I was able to go to the bathroom without crying – I had to mentally prepare myself well in advance and sex and all that was weird for a while, so with my 3rd child I talked with my midwife in advance, because I wanted and epis. that time rather than having to heal from another bad tear. At the delivery they ended up giving me a small cut and very carefully stitched me back up and I healed completely in 4 weeks – I was so happy! (& so was my husband – right back to sex after 4 weeks and never a problem since.) I think you have a much more caring doctor this time around so I think that can make all the difference!
First baby was 9lbs 3oz, three days of labor, 3 hours of pushing, 4th degree laceration, 2 1/2 hours of sewing to repair the damage done (husband stopped counting after 150 stitches). Total nightmare. Second baby, 10lbs, 3 hours total for labor, pushing, and delivery. 3rd degree laceration but only 50 stitches. Only difference, no episiotomy with second delivery because the doctor didn’t have time to do one! I know 50 stitches sounds like a lot of stitches but the difference in healing was like night and day. 4 weeks as opposed to three months. And you know, for years afterward I could tell you when it was going to rain because of that scar!
Completely natural childbirth. Tearing requiring 7 stitches. Yeah it itched. And for years afterwards, I could feel where I had been stitched. It didn’t bother me, but it was kindve strange.
I would take the other ladies recommendations in regards to the birthing ball and such and since you’ve made your case with your OB, I think you are well on your way to not having the dots connected so to speak. Although I have two other children, I ended up having c-sections with both of them, so I have nothing for ya. (although I can say, if that does happen-the c-it isn’t the end of the world, I did fine with recovery after both.
May your labor be short and as pain free as possible.
I didn’t have time to read through all the comments–ask and ye shall receive, eh?–but I recommend a thing called the Epi-No. It’s basically a balloon that you inflate to stretch your perineum. The more you strech, the larger you are able to inflate it. It’s really weird and terribly embarrassing when you have to ask your husband to help you with it becasue you can’t see past your enormous belly, BUT it really works. Had an 8.11 baby who came out in 3 pushes, and needed only 2 small stiches. You should be able to get it at a cruchy birthing place. And I highly recommend Tucks pads. They are a lifesaver becasue even with minimal damage, I couldn’t sit right for weeks, and it took a long time beore I felt more like myself again. Good luck!
I would recommend going with a midwife. There are midwives out there that are part of ob practices and deliver at hospitals if you look enough. I switched to one at 30 weeks and I’m so glad I did. She’s awesome for so many reasons including her really low rates of episitomies. She slows things down to give your body time to catch up, practices perineal massage, etc.
I ended up needing a c-section despite all of my midwife and doula’s efforts (they tried tons of stuff to prevent one that an ob wouldn’t have tried but it did no good) so I was glad my midwife was based at a hospital.
My husband was very dubious when I told him I wanted to swich at 30 weeks but after I switched and he met my midwife he told me he never wanted me to switch back to an ob.
Just so you know, a midwife can also handle most well woman care.
I had a big ole’ episiotimy with my first baby, so I was convinced I would tear or need another epis. with the second. Nope! My second baby came out (and my dr. made sure to take him out slowly so I wouldn’t tear) and I didn’t tear at all! I kept thanking my dr. for not letting me tear. There is hope sista!
I had an episiotomy with my son. I pushed & pushed but there was no way his big ole’ head was going to come out. As soon as I had it he flew out without even a push. But I also had a Y shaped tear. I hurt so bad for so long. It was 6 months before my husband & I could have sex.
I know someone who tore to her rectum with her first & didn’t tear at all with her 2nd. Her ob did perineal massage during labor- they brought a bottle of olive oil & a crock pot to the hospital & it worked.
I agree with everything that Heather said. I prepared for the birth of my daughter with the hypnobirthing method which recommends perineal massage in the last few weeks before your due date. If you do nothing else, do this. I totally believe that the oils and the stretching not only softened the area, but prepared my body for what it would feel like for that area to stretch so much and not tear. N.B. Not to toot my own horn, or hoo-hoo, so to speak, but I was pretty darned tight once upon a time, so I was quite nervous about the whole human being shooting out of my cooch thing. The huz did the massage for me after sex, which I found to be the most comfortable time, because my body was more relaxed after I’d had my, ahem, jollies… And it was good to give the old huz an important pre-birth job to do other than assembling baby stuff. As for the aforementioned tightness, after just a couple of weeks of massage (which should involve both rubbing and stretching), I couldn’t believe the progress in terms of how much stretching I was able to tolerate. Just goes to show that this shit works!
In the end, my baby was three weeks late and posterior (sunny side up) at birth, and I had her naturally at a birthing center in London with amazing midwives who never told me what to do and trusted my judgement. I pushed for three hours before my daughter was finally born on a birthing stool, and you know what? I didn’t have a single tear. Not one. I think this was due to a combo of me being in an upright/squatting position (which has been proven to reduce tearing), the hypnobirthing technique of not pushing until the very end and then only with steady pushes, and most of all the perineal massage prep. My body already knew the feeling of stretching there so I wasn’t afraid of it and I never tensed up. I think tensing up contributes a lot to tearing, as it does with other injuries.
Anyway, I wish you the best of luck. I absolutely believe that you can have the kind of natural birth you want, especially if you have the right kind of health care support around you, people who are both knowledgeable and willing to let you have the power in your birthing situation. I know this can be hard to come by in the US (this is why I had my baby in the UK), but if you look hard enough, you can find it. I think midwives are the way to go if you can find one who clicks with you and who’s had a lot of experience.
Also, I forgot to say that in UK, it is considered common medical knowledge that a tear (which is jagged and can therefore knit together better) heals much more easily than an incision (which is straight). The practice of episiotomies seems to be purely for the convenience of doctors and has no discernible health benefits for mother or baby. It’s a lot quicker and simpler for a doctor to cut the baby out and then sew up a straight cut rather than to wait for the natural process of birth to occur and then sew up a jagged tear.
OMG, I’m sitting here with tears in my eyes and my heart racing. You ladies have my bits scared to bits now …
I spoke about this with my ob-gyn (sadly, there is only one hospital in our area that delivers babies and has a NICU–only one!!!), and he gave me the old “cut is better than tear” line, besides letting me know that if I “wanted to drop the kid like a Chinese rice patty worker” and bring it in later, that’d be okay with him, too. Of course, he said that he’s the one in charge and I should follow his judgment. And now I’m really scared.
Will definitely get the epi-no and discuss the oil and stretching with the hubs. And maybe look for a different ob/gyn.
oh. my. god. charlotte. who does that @#$%&^*! think he is!?!? first of all this is your birth, you are in charge. second of all that is the most racist, ignorant, ridiculous thing i’ve heard in a long time. run away from that dick of a doctor, please!! if you absolutely must deliver in that hospital (homebirth? birth centre? hospital further away?) please get yourself a couple of good doulas, you’re going to need all the support you can get. *hugs*
It may not be your thing, but I am planning on a water birth with midwives (at home). Much less tearing (if at all) and no doctors grabbing at me while I am going through the process. I can’t even imagine a scalpel coming near my parts like that. We are running on me and the baby’s time schedule…not the stupid knife-happy doctor’s.
Search the internet for more info and YouTube has tons of videos. Just my two cents!
Not speaking from first hand experience, but just throwing in another yes it can be done. My step sister was ready to plan a c section after her first birth because of the pain of having and healing from her epi. She gave birth to a larger boy the second time around, and did not need one. She too had a Dr with a less than stellar bedside manner the first time around (her Dr and his partner would take on call days so whoever was on call delivered). She got her Dr to sechedule induction so he could be on there for her 2nd, but she went into labor at 3 am the night before induction.
I demanded to not get an episiotomy with my first (my OB thought I was crazy) but I tore horribly (3rd degree).
My second was smaller (I made sure to be more careful with my sugar intake the second time around) and I barely had a 2nd degree tear along the scar tissue from my old tear. This labor was also unmedicated, which helped me birth out my son slowly and more controlled (versus the vacuum extractor the first time around).
So yeah, I don’t know what type of birth you have planned, but in case you are going the natural route, I recommend “Birthing from Within.” It’s pretty new-agey, but I figure you’re already half-way granola if you end up reading it. I like it’s take on childbirth — it’s painful, dirty, and can be noisy; here are the tools to deal with it.
Episiotomies are unnecessary and will do more damage than good. Imagine holding a piece of fabric taut, then snip into it with a pair of scissors. The fabric will end up tearing more easily, right? Docs just don’t like sewing up the jaggies because it’s more difficult and painstaking as opposed to a nice clean line. But it’s your body, not theirs.
You know, and this is just speculation, but I wonder how many people get cut because Dr’s are scarred of malpractice suits (I hear obgyn’s are the most sued people withing the medical arena). It’s sad that you can’t trust a trained professional do their job (which is taking care of you and baby) better than worrying about protecting themselves. And yes there are lots of good caring Dr’s but sadly I am not convinced that they aren’t the minority now.
two words…elective c-section! No way was I going to mess up my vag and future sex life for a natural delivery. I did have twins, so that made my decision easier. Too many of my nurses and docs said they would have an elective c bc of messing up the vag muscles. Yikes!
I had an one w/ first and second children….awful, painful, but not some of the horror stories my poor friends had. With last child, I was progressing so fast doctor didn’t have time and I had a small tear.
What a breeze compared to the episiotomy. My husband couldn’t believe I was practically dancing a jig just hours after the birth. I didn’t even have to use the Dermaplast or as we call it Derma-blast!
My sister and bff had the same experience after having episiotomies w/ first births and tearing w/ their last.
Good luck!
DesignMama reminded me of a really helpful tip my midwife gave me: cut down on sugar and eat wheat free. It helps to reduce swelling in general, but especially in the pelvic region which can have a huge impact on not tearing.
And I think Courtney is absolutely right about the malpractice suits leading to more cutting and interventions in general. I had my baby in the UK where there is very little litigation and there is also a lot less medical intervention in birthing, plus a lot more midwife assisted births. Makes you think.
Avoid doctor directed pushing and you won’t tear bad enough to mention, if at all. Check the Hypnobirthing method, it’s a little hippy dippy, and you won’t have a pain free birth as they say, but the methods work. I tore just a little bit in front as the baby turned on the way out. Just a few stitches. Doesn’t work with an epidural though. Good luck with the birth! -J
I had an episotomy after some stretching and 2 hours of pushing with my first. I had a second opinion on how it was sewn up, and he did a good job. i healed and could wipe within a week.
With my second, he waited until i started to tear before giving me one. I really think it is the little tears (they were lateral) that hurt the worse the second time. My baby had a HUGE head the second time around too, so maybe that was the issue.
The old girl ain’t what she used to be.
worse than female circumsion i believe but then again they saved my babys life soo i am not really mad at the ObGyn.who pisses me off is my Gp, after 2 years of going and complaining about back pain and pevic pain that nerly floors me i decided to be rebelious and go to the hospital without referal and insist to the gyno only to hear that my vag wall is falling and i have a retocele and perineal damage! I don’t understand what this all means yet but all i know is that Gp in holland are the worst doctors in the world.If this fool just looked at the info they send after you give birth he might have seen the link between my pain and this form of genital mutilation..what i want to hear are the horror stories ,,genital prolaspe and about pain.I hav only one baby so i can’t understand why this happen ed to me
I had only interns attending my first birth and they did a real hack job of my episiotomy (which I also told them I didn`t want) . . . and get this . . . I hadn`t even STARTED PUSHING YET! :S
Like you, I never fully recovered. But, the good news, with my second, I didn`t have the episiotomy and did tear, but even so I was actually able to sit down just fine like two days afterwards.It healed super fast. So while tear-free might be nice . . . tearing is WAY better than cutting.