 |
 |
 |
|
|
|||
|
|
||||
|
||||
Re: EpisiotomyFrom: D. Ashley Hill, M.D. (anonymous@obgyn.net)Tue, 20 May 1997 18:13:03 -0500 (CDT)
At Mon, 19 May 1997, K.Tice wrote:
>
>* I forgot to warn you about episiotomy. Your md might sugar coat it but many women who have had them complain of painful sex for years after the birth. Some authors have gone as far as to call it genital mutilation.
>I would tend to take personal advice like this seriously, especially as it is noted that some women this person knows have experienced bad outcomes as a result of episiotomies. Karen- I don't routinely cut episiotomies (less than 5% of my deliveries). However, while anecdotes like you received are important, they will never replace well-controlled scientific studies in the medical literature, where hundreds, and sometimes thousands, of patients are examined and their symptoms are documented and analyzed systematically. The medical literature is pretty straightforward on episiotomies: under *most* circumstances, they lead to worse tears and more damage. However, in some cases an episiotomy is necessary (for example, when the baby's heart rate is drastically low and a rapid delivery is critical). And, while in some cases an episiotomy is more painful than a c/section, I would guess the reverse is true 9/10 times. I have seen patients with problems after an episiotomy, the most common being painful intercourse. A simple steroid injection is almost always curative. Other possible problems include anal incontinence (with a very deep episiotomy), infection (quite rare), or a blood clot (also rare). Common problems with a c/section include infection (up to 50% in some areas), bleeding, scar tissue formation, cutting through the bladder or intestines, anemia, and post-operative wound breakdown. An episiotomy is an approximately 2-3 inch cut through the muscles and tissue between the vagina and anus (usually), called the perineum. A c/section is 5-6 inch cut through the skin of the abdomen, the tough fascia, the peritoneum, the elastic tissue above the bladder, the thick muscle of the uterus, and the water bag. There is a dramatically increased chance of serious infection with a c/section (infections of an episiotomy are exceedingly rare). In addition, the blood loss during a c/section averages between 500-1000cc (1 liter) whereas it's between 200-500cc with a vaginal delivery (usually about 1/3 the amount of a c/section). Finally, the chance of damage to the bladder or intestines is almost nil with a vaginal delivery, while they are certainly possible with a c/section. Whether or not you choose to have a try at a vaginal delivery or a repeat c/section is a very personal choice. It seems that a major component of that is your concern about an episiotomy. Surely you can talk this important concern over with your doctor and let he or she know that you absolutely do *not* want an episiotomy. I can't imagine that a doctor would go against such a straightforward and reasonable wish. Best of luck to you,
-- Ashley Hill D. Ashley Hill, M.D. Assistant Director, Department of Ob/Gyn Florida Hospital Family Practice Residency Orlando, FL dahmd@gate.net
|
|
Return to ![[ Women's Health Forum ]](http://www.obgyn.net/images_women/wh-forum.gif)
Report TECHNICAL Problems ONLY to: webmaster@obgyn.net
Last Updated: Wed Dec 2 06:58:06 2009
Women's Insurance Checklist from Auto Insurance Quote
home | medical professionals | women | industry | forums | international