Comments on: “Well, I Haven’t Seen A Woman Give Birth In 8 Years Without One”

By: Andy

Andy — Sun, 03 Jan 2010 21:18:42 +0000

In the UK, they are introducing a system called revalidation, where doctors are expected to update skills on a regular basis and show evidence that their skills are current. I think there will be an element of testing involved- it will certainly be formally assessed. As you may imagine, the doctors are up in arms, but it is being introduced to avoid the situation where outdated notions and ‘we’ve always done it’ inform their practice

By: Andy

Andy — Sun, 03 Jan 2010 21:13:05 +0000

I have been a midwife 8 and a bit years, and I have done 5 episiotomies. Each of those has been to expedite delivery because of distress. We don’t do them routinely over here, and haven’t since the eighties I think. There used to be 2 criteria for getting the scissors out: 1) first baby, and 2) previous episiotomy. There has been a lot of research done over the years that has shown that episiotomy doesn’t reduce the risk of a serious tear. It also may increase the risk of more extensive damage from the cut extending. It has also been shown that a tear will heal much better than a cut anyway, because a cut crushes and bruises the tissues, causing odema and a wound that doesn’t come together well. A tear occurs along natural break lines around the cell walls, so the wound naturally closes better. I haven’t got the refrences to hand, but I will do a search later and put it on here.
Andy

By: Kat

Kat — Sun, 03 Jan 2010 16:27:01 +0000

Another thing to consider is the degree of tearing.

An episiotomy cuts through the skin and muscle, which if it happened naturally would be second-degree tearing.

If you tear just a little bit, you might only have tearing in the skin (first degree). Obviously the lesser amount of damage will heal faster and easier.

And, once your tissues are cut, they are more likely to tear further. Like when you cut a slit in a piece of cloth, it is much easier to just rip it all the way through than to rip a cloth without a slit in it. The analogy has been mentioned before but it bears repeating because it is true!

By: Jane

Jane — Sun, 03 Jan 2010 12:43:06 +0000

Think about this, though: they want you to avoid tearing by CUTTING you open.

That’s like saying, “You want to avoid a broken leg, so instead we’ll smash your kneecap with this hammer.”

And no,I’ve found that I have stretchy skin and I delivered four of my five babies without tearing. The only time I had a tear was when the doctor used the episiotomy scissors.

By: JPeaslee

JPeaslee — Sun, 03 Jan 2010 11:41:02 +0000

Until I started reading this site, I always assumed tearing was something that was inevitable (and I’m 21). I can’t tell you how much of a relief it is to know now that it can be avoided, and obviously not just by getting a completely useless episiotomy.

By: Sheva

Sheva — Thu, 31 Dec 2009 16:04:53 +0000

It’s heartwarming to hear that some caregivers have a heart. (And a brain!) Thank you!

By: Sheva

Sheva — Thu, 31 Dec 2009 16:02:46 +0000

You made me laugh out loud! Thank you, I needed that!
Sheesh, what a visual!!

By: Courtney

Courtney — Thu, 31 Dec 2009 01:37:20 +0000

On my second delivery my OB (who I had to switch to due to insurance reasons) insisted that I have needed one even though I had my first without one and no tears. Yes my second child was slightly larger (10 ounces), but not that much bigger.

By: Kristi G

Kristi G — Thu, 31 Dec 2009 01:13:37 +0000

This is the story I submitted. It took place 10 years ago with my first baby. I was only 16 (17 when I had her). I ended up doing one test push, she crowned, the dang doctor was nowhere to be found and the floor Dr. was in another birth. I was *forced* to lay there and not push for 15 minutes. The doctor came in and slid out into her ungloved hands. No tears, never any pain. My second daughter was born in 2006 and I had her under the care of a midwife in a birth center. She too was a one pusher, had a big head and came out with her hand on her face and I still didn’t tear. I am now pregnant with my 3rd DAUGHTER and we are planning a homebirth. I hear and see the craziest things with OB’s! I submitted two more stories, but I am not sure they made the cut!

By: Heather (qtberryhead)

Heather (qtberryhead) — Wed, 30 Dec 2009 20:14:39 +0000

Saying “I’m confused” was tongue in cheek. haha.
The thing that confuses me is the supposed logic behind statements made by these cavepeople, er, OB’s.
As many of you have pointed out, OB’s often don’t know anything else. My ex and his girlfriend are getting their bachelors in nursing and when I skimmed through their textbooks there was a miniscule chapter on “normal” labor, and that labor included the use of an episiotomy.
I think too many OB’s get into this “faster is better” mindset. Like the sooner we get the baby born, the sooner we can stop worrying about things that can go wrong. They fail to associate newborn issues with labor interventions.
There are reasons why we women undergo the things we do in labor. We get loose stools at the beginning, we crave light snacks and water to sustain us. Our thoughts turn inward while we grasp the realization of what we are doing and where we are going with this new life altering experience. We feel compelled to walk around, moan, grunt. We get the urge to push when it’s needed, and we feel burning when we need to back off. An intact perineum contracts on the babies chest in order to expell excess fluid from the lungs. These are things that women need to experience in order to birth a baby in the safest way possible. Why are people confounded by that?
Sorry to get all gooey…