Re: Delivery qns

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I can't offer much advise about the episiotomy issue in terms of what you should do (find another doc this late in the game, etc.), but I feel for you. I'm personally very much against routine episiotomies (and it's a rather heated debate!) and feel that it should be a decision that comes from the mother based on education, research and preparation (meaning it doesn't seem rational to do absolutely no research on perinneal trauma, then march in to your OB and declair, "NO EPISIOTOMY!"...knowledge is power). I personally would be VERY concerned about a doctor who says that 80% of his first-time moms end up with them. There are many ways to lessen the risks of episiotomies AND perinneal trauma (perinneal massage, slow directed pushing at the crowining stage, among others), but your doctor has to be on the same page as you with this. I wish I had some advice to offer - maybe you could do a little research on your own, gather as much data as you can, then call him to earnestly dicuss your concerns and how you'd like to handle this issue. I know that there have been instances in which they have been necessary, but I also believe that the birthing mother should be involved in the decision of whether or not she gets cut -- certainly not as a course of "routine."

Hope everything works out for you...

Tonja

At Thu, 31 Aug 2000, Rice wrote: >
>I have posted here before and have gotten some very helpful feedback
>--thanks!
>I am 39 wks (1st pregnancy) and I am nowhere--not effaced, dilated, baby
>still positioned too high..is it likely that baby will be late??
>
>2. How common are tears--w/ or without an episiotomy that extend
>frontward thru the vagina and clitoral area. One of the drs in the
>practice said that he sees one of these every other month which
>translates into 5% of his deliveries. Is this possible? He said that
>80% of his 1st timers get episiotomies--(Which probably means closer to
>100%) to avoid more uncontrolled tears. I was very much trying to avoid
>an episiotomy if possible.
>
>3. Would it be unwise to induce (after 40 wks) to get a dr with a lower
>episiotomy and tear rate?(Although the lowest episiotomy rate of any dr
>is still around 50%) In this practice they will make no changes to the
>call schedule to accomodate pt preferences --except for scheduled
>deliveries --pts have absolutely no say who delivers baby.
>
>Sorry this is so long!!! I am getting very nervous...

--
Tonja Brossette
OBGYN.net Coordinator
Pregnancy & Birth
tonja.brossette@obgyn.net

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