Posted by My OB said WHAT?!?.
Aug
23
Posted by My OB said WHAT?!?.
“…You’ll Look Like Hamburger…”
“If I don’t give you an episiotomy, you’ll look like hamburger, and that wouldn’t be fair to your husband.” – OB to mother who had had a 4th degree tear during her previous birth.
There are 40 comments to this post.
beccaisadoula had this to say,
Aug 23, 2010 @ 4:56 am (Quote)
Yeah, ‘cuz the ONLY thing my husband and I are concerned about is the *look* of my vagina…
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Let’s analyze the manipulative tactics, shall we?
1) Crystal-balling. Doctor *knows* she’ll “look like hamburger.”
2) Emotional blackmail: You need to submit to this for your husband’s sake, otherwise he’ll be disappointed
3) The fairness gambit: If you don’t do this, you’re being unfair to your husband, ie–you’re being selfish.
4) The self-esteem blow: You’ve already torn very very badly, so I’ll make a comment implying you are ALREADY a freak, and you don’t want to feel more freakish, do you?
5) The gift switch: “If I don’t give you an episiotomy” implies the doctor is giving the mother a lovely gift, the gift of a beautiful vulva. If the doctor had said, “If I don’t cut an episiotomy,” it would not sound like the doctor was being eminently selfless and giving.
Five tactics in one sentence: excellent work, doctor! I hope the mother ran as far and as fast as she could from you and your practice.
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doulamommy Reply:
August 23rd, 2010 at 1:24 pm (Quote)
I would laugh hysterically, because your assessment is so spot-on, but it’s too sad.
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So, he’s just basically stated he is completely incompetent at correctly repairing torn perineal tissue. He should really take some continuing ed classes to fix that.
Or find a new line of work, like plumbing. Anything that doesn’t involve Women, Babies, and Major Life-Changing Events in any form.
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Alyson Miers had this to say,
Aug 23, 2010 @ 6:22 am (Quote)
Hey, Doctor Stabby-Hands, my partner cares much more about my quality of life than about the way my snatch looks after bringing a life into the world. I guess that’s a distinction you wouldn’t understand.
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Cmat Reply:
August 23rd, 2010 at 7:10 am (Quote)
No kidding. My husband was simply in awe of what I could withstand and what I could do. In awe of the fact that his first child had just been born. He didn’t give a flip how/where I tore. He showed nothing but concern for the fact that I was uncomfortable for a few days and made sure I had anything I needed. Nowhere in there did he express concern for the cosmetic appearance of things.
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Frankly, my episiotomy turned out fine, healed great, and would have been a hell of a lot worse (9 pound baby) if it’d just torn. A tear is unpredictable and uncontrollable. And yeah, I *do* care what my vagoo looks like. There’s not a damn thing wrong with a woman caring about what it does to her body, and . . . hamburger vag = gross.
Yeah, he phrased it badly, but this natural tear stuff (yeah, I’ve seen the cute little studies) is ludicrous.
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Heather P Reply:
August 23rd, 2010 at 10:43 am (Quote)
I see you’ve been indoctrinated into the “episiotomy saved my vag” school. I assure you that women who don’t want episiotomies care very much happens to their perineums. That’s why they don’t want a scissor-happy doc coming at them.
My baby wasn’t as large as yours (8lbs, 2oz) but she did have a gigantic head. I had a first degree tear. With an episiotomy I’d have had a guaranteed second degree. My vag does not look like hamburger. If the doctor had “let” me push how I felt like instead of having me strain and hold my breath, I probably wouldn’t have torn at all.
I didn’t tear at all with my second baby. Mostly because nobody came near my perineum at all and I didn’t purple push.
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Pigbot Reply:
August 23rd, 2010 at 12:04 pm (Quote)
No, I’ve been indoctrinated into the “I like science and simply spreading your legs and getting knocked up does not make you a medical professional” school.
I had no problems with my cut, the healing, or anything related. Why don’t you go back to the drum circle and leave the medicine to the educated?
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Dee Reply:
August 23rd, 2010 at 1:33 pm (Quote)
I AM educated. This is from the 2005 article: “Outcomes of Routine Episiotomy: A Systematic Review” by Katherine Hartmann, MD, PhD; Meera Viswanathan, PhD; Rachel Palmieri, BS; Gerald Gartlehner, MD, MPH; John Thorp, Jr, MD; Kathleen N. Lohr, PhD, in JAMA. 2005;293:2141-2148.
“Conclusions Evidence does not support maternal benefits traditionally ascribed to routine episiotomy. In fact, outcomes with episiotomy can be considered worse since some proportion of women who would have had lesser injury instead had a surgical incision.”
I think JAMA is a pretty reliable place to look for info. Just because I’m not a medical doctor doesn’t mean I want to be ignorant about medical procedures, childbirth, and other related items.
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Heather P Reply:
August 23rd, 2010 at 2:02 pm (Quote)
See Dee’s link.
I’m not one to lay back and thank a doctor for cutting when I don’t need it. Evidence based medicine does not support episiotomies. They do not heal better than a natural tear, no matter what some doctors claim.
I wanted to keep it civilized but your comment about the “cute” studies by JAMA opened the door. I am not uneducated and I’ve never been to a drum circle. Yes, I had procreative sex to have children, but that does not mean that I have lost my autonomy and will blindly hand my body over to other to do as they see fit.
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doulamommy Reply:
August 23rd, 2010 at 1:35 pm (Quote)
I’m glad that you were happy with your episiotomy. That doesn’t mean that women are nuts for wanting to keep the integrity of their perineums. And if you like science so much, what’s with the “cute” comment? There is no research that shows routine episiotomy results in better outcomes for women. In fact the research shows that it results in WORSE outcomes. And it also shows that a tear IS controllable – by physiological pushing in an upright position, you can avoid one completely.
Anyway, what does the hamburger comment mean anyway? Is that related to the idea that any vaginal birth will RUIN your vagina and it will thereafter look sooo gross that your husband will never want to look at it again? Puhleaze.
I had a very minor 1st degree tear with my first, and my vagina still looks great. Plus with both of my babies, I was completely recovered by the following day and having great sex again within a couple of weeks. Many women who have epis (not necessarily you, that is) still report pain during sex for months or years afterward, and that’s not counting the weeks of healing time.
Obviously it’s a case-by-case thing, and if you’re happy with a guaranteed 2nd-degree injury, and comfortable with the risks, then enjoy your scissored vagina. 
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Jane Reply:
August 23rd, 2010 at 3:22 pm (Quote)
Surely you would agree that just as you have the right to prefer an episiotomy, other women have the right to choose a tear.
And surely you would agree that women have the right to make this decision about their bodies without emotional blackmail or lies from the physician.
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I think the doc was talking more about function than appearance, which is no better, I think, and possibly worse.
The doc is supposed to explain things, but that’s no license to be crude or gross.
“I think you may tear with substantial damage if you don’t consent to an episiotomy.”
(Wrong info, but said nicely, at least.)
“Truth is, I’m not confident in my stitching capabilities and you may be wrecked ‘down there’ when I’m done with you if you tear naturally, aka unevenly. I’d rather scare you into a nice, neat episiotomy so that even though you’ll be in wretched pain I’ll be able to say honestly that the scar is healing nicely (aka it’s YOU, not ME).”
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Yeah, Dr Don’t let me look like a hamburger! I’d much rather have you cut me, let me tear to the fourth degree and be left with a rectocele for the rest of my life. I’m sure my husband would much rather me having bowel incontinence then a hamburger! Thanks for looking out for me Doc!
(what the heck is “looking like a hamburger” I’m pretty sure it will still look like a vulva cut or no cut, thx!)
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Alyson Miers had this to say,
Aug 23, 2010 @ 3:03 pm (Quote)
Too bad I spend so much time reading research papers on evidence-based maternity care. Otherwise I might have more time for drum circles.
I guess it’s more work to use one’s reading comprehension and critical thinking skills than to bow down to claims from authority from anyone with a license to cut, but that is my cross to bear. :p
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Jane Reply:
August 23rd, 2010 at 3:24 pm (Quote)
Maybe you can read the peer-reviewed journals to the rest of us during our next seance under the twinkle lights?
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Alyson Miers Reply:
August 23rd, 2010 at 3:34 pm (Quote)
Can research papers be worked into Hypnobirthing routines? Or maybe I could organize a drum circle to go accompany the statistics from the latest obstetrical literature?
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“Actually, Doc, my husband LOVES hamburgers! Can you call down to the cafeteria to see if they can send up some cheese and ketchup?”
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sara Reply:
August 24th, 2010 at 8:14 am (Quote)
rofl. my husband LOVES hamburgers also.
I can’t imagine anyone’s vagina looking like a hamburger after a birth, though…that’s pretty extreme. I mean, birth is traumatic, and I’m sure everyone’s vagina looks a little strange after it, but like a hamburger?! If that’s what this doc is used to seeing…maybe he/she is doing something wrong…
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My sister had her baby last night. She was in labour for 9 hrs. She pushed for 10 minutes and the baby was born. However, the OB arrived after only about 5 minutes of pushing and declared that the baby would not come out unless he cut her. So, after 5 min of pushing, flat on her back, her OB gave her a 2-3 degree cut so she could birth her …… wait for it 6lb 12 oz baby. And she is convinced he would not have done it if she hadn’t needed it done. Oh please ….
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sara Reply:
August 24th, 2010 at 8:16 am (Quote)
That is terrible. I was afraid of that which is why I made sure the doc knew how I felt about any sharp objects around my vagina while I was pushing (NO CUTTING!). My baby was almost the same size, also. If babies that size couldn’t be born without doctors cutting, most of us wouldn’t be here.
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Gemma had this to say,
Aug 24, 2010 @ 3:40 am (Quote)
My husband happens to think that my genetalia are even more amazing having birthed all 3 of his children! I ‘had’ to have episiotomies with the first 1 and it took forever to heal!! My other 2 I barely grazed! My third being 9lb 5oz!! Episiotomies should NOT be a standard procedure!
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The Deranged Housewife had this to say,
Aug 24, 2010 @ 8:47 am (Quote)
OK, about the only thing I can think of here is “What a son of a b!tch.” As if this woman has no feelings, no opinion whatsoever, and is only there as an object to please her husband. 
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2 thoughts. First one was I would think that a woman who experienced a fourth degree tear into her anus would be screening her next doctor based on his/her philosophy on episiotomy up front. I’m hoping this is the answer to a screening question and not a conversation during her fourth birth with Dr. waving scissors around. Second thought, well at least his is admitting that he thinks of her as meat. A prime cut of steak if I cut you. Hamburger if we let you tear! If he was really concerned he would be talking about her bowel function rather than her husband’s opinion of the visual result. Disgusting
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Charity had this to say,
Aug 26, 2010 @ 4:57 pm (Quote)
K… My first was born with a 52cm head and I didn’t tear. If doctors would let women push the way they’re comfortable, tears would be a lot less likely. My midwife was insisting I push harder for longer, but my body told me otherwise. I listened to my body and had no problems.
Mama: Your OB was a control-freak jerk.
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Funny, I did have an episiotomy w/ baby #1 (CPM-attended homebirth) after 3 hours of hard pushing in a wide range of positions. I had been a ballet dancer and my pelvic floor muscles were very tight. Since it was only the 2nd episiotomy the midwife had done in 10 years of practice, I trusted her judgment. The funny part is my husband has always described the look of it all, as I was later being sewn up, as, wait for it. . . hamburger! So maybe the OB got it backwards? Or doesn’t know what hamburger looks like.
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Susan Peterson had this to say,
Aug 29, 2010 @ 8:06 am (Quote)
I really find it offensive that the doctor thinks of a woman as an object for her husband’s use, and that he thinks of himself as trying to handle another man’s possession to keep it in good shape for his use and pleasure. I also find it offensive that he expects the woman to think of herself that way.
This is all besides the fact that what he is saying is absolute nonsense. If you get into an upright position and push at your own rate you are not likely to tear. I had a large episiotomy with an earlier baby delivered with forceps (back in the 1970′s) but I later delivered very large babies (10+lbs) without tearing at all, even along the episiotomy scar. I had pain with sex after the forceps episiotomy delivery, but no problems after the natural births.
I am glad the woman who reported this heard it before it was too late and was able to avoid this doctor!
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Serene Reply:
September 13th, 2010 at 5:54 am (Quote)
have to correct you. Apparently its nothing to do with being upright or laying, provided mum feels it is the right position for HER to be in. Twice now I have been well-intentioned of birthing upright, but last minute I lay down on my side, head lower than the bed. Apparently the risk of tearing decreases as mum is allowed to follow her instincts, but is not directly linked to position in and of itself.
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I hope the OP reported this idiot…can’t imagine what my DH would have said…
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