Having an episiotomy is one of the more unpleasant aspects of having a baby. If you’ve never heard the term, it is a cut made in the perineum, which is located between the vagina and rectum. Doctors do more episiotomies than midwives. The reasons given are that they prevent tearing and make the birth faster. There is mounting evidence that neither of these statements is true.
There are times when an episiotomy is needed: If the baby is in distress and must get out faster or if the mother has an unusual medical condition that could require the cut.
There are some problems that can result from an episiotomy such as: more blood loss, higher risk of infection, longer healing time, longer time to resume normal sexual relations, more pain, and for some women it can result in more tearing. This was true in my case. With my second birth, I ended up with a fourth degree tear after an episiotomy. The pain was severe and lasted for weeks after the birth.
There are some ways to avoid an episiotomy. Do your Kegel exercises throughout your pregnancy to strengthen the muscles in the perineum. Lie on your side during labor, rather than on your back. Use a variety of positions during labor to help the area stretch naturally. Don’t use stirrups for pushing and push when your body tells you to, rather than when someone else tells you it’s time to push. Warm compresses can be used during pushing to help prevent tearing. Having a natural, drug free birth is better for avoiding an episiotomy. This is because you can feel when it’s time to push and respond to your body’s signals better when you aren’t numb.
Perineal massage can help reduce the need for the cut. This should be done in the last two months of pregnancy to help stretch and prepare the area for birth. Massage should be done every day for ten minutes. It can be done in a warm bath or in bed with a lubricant. Gently stretch the area for about ten minutes during the last month or two of pregnancy for best results. This helps the skin stretch and will help prevent tearing.
If you end up having an episiotomy, there are ways to help the area heal faster after the birth. Use ice packs for the first few days after the baby is born. Sitz baths can help the healing process. In my case, these just made the pain worse, so I stopped using them. I found relief in a product called Dermoplast, which is a spray analgesic. I used about two cans of this with my second after I had the bad tearing with the episiotomy.