PREGNANCY-BIRTH Messages for March, 1999: Re: How to Avoid Episiotomy?

Re: How to Avoid Episiotomy?

From: William D. McIntosh, MD (anonymous@obgyn.net)
Thu, 11 Mar 1999 17:59:30 -0600 (CST)

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At Thu, 11 Mar 1999, anonymous@obgyn.net wrote: >
>How does a woman avoid episiotomy during delivery?
>Just relax? Can a woman refuse to have an episiotomy if it
>is the doctor's/hospital's routine practice to perform one?
>(I don't know the policy here in Canada). Is it better to get stitched
>up after any tear than to have an episiotomy?
>I read that having an episiotomy INCREASES the incidence of tearing
>because it is like fabric-if you snip the edge it rips more easily than
>if there's no cut.
>
>Thanks for the advice.

The most important thing that you can do to reduce the risk of an episiotomy is to talk with your physician about their feelings about this issue. To go on with a recurring theme of my posts, an episiotomy is a tool, a not very useful tool in my opinion, but a tool nontheless. You should never completely rule out the use of a tool, because there is always that 1/100 chance that you might need it very badly indeed. Be upfront with your doc. You don't want one if it can be avoided, but don't tie his/her hands over matters that cannot be predicted.

Episiotomies that do not extend are technically easier to fix than tears, though any competent OB should be able to take care of either half asleep in a hurricane, while standing on his head. However, you are correct, episiotomies are quite liable to tear further, for precisely the reason you name.

When the time comes, focus on the lessons that you have absorbed in your prenatal care, listen very carefully when the doc talks to you, and try to follow the instructions that you will be given. If you can ease the head out in a controlled fashion, there will be less damage done to your perineum.

-- William D. McIntosh, MD Clarksville, TN

This is for educational purposes only. It is not intended to replace consultation and examination by your physician or other health care provider.

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