Is Episiotomy Necessary?
Episiotomy is a surgical incision into
the area between vagina and rectum to
enlarge the opening through which the
baby will be born. After the birth, the
edges of the cut are frozen and sewn
back together.
It is routinely performed in 40 to 80
percent of births, especially first
births. Many women feel that this cut
is the most disabling part of
childbirth.
Why Is It Done?
Many doctors perform episiotomies
without being aware that their routine
use has no scientific basis.
Valid reasons for episiotomy include
forceps delivery, breach baby,
premature delivery, and finally to
speed delivery if baby's heart rate
drops or baby shows signs of distress.
Side Effects
- Episiotomy may extend into rectum.
- Pain and bleeding.
- Stitches can breakdown; delayed
healing.
- Painful sex, may last up to 6 months.
What It Does Not Do
- Prevent later bladder or bowel
problems.
- Make vagina tighter.
- Heal faster or with less scarring. In
fact, small to medium tears heal more
easily and with less pain.
Prevention Before Birth
- Practise relaxation, toning and
relaxation of pelvic floor muscles i.e.
do Kegel's exercises 25 to 50 times a
day.
- Practice breathing that stops pushing,
a pant and blow-type of breath like
blowing on hot soup in rapid short
breaths.
- Find a good midwife or sympathetic
physician.
Prevention During Birth
- Choose semi-upright or squatting
position to allow gravity to help you.
- Push for shorter time periods, only
when urge overwhelming.
- Keep mouth loose and relaxed while
pushing.
- Let baby's head and shoulders come out
as slowly as possible, between
contractions, with coaching from doctor
or midwife.
- Use the pant and blow type of breathing
to stop pushing.
