Aside from cesarean section (c-section) childbirth, having an episiotomy is the one aspect of childbirth that women dread. An episiotomy is done when the doctor makes an incision to enlarge the opening of the vagina. An episiotomy is supposed to speed the delivery of the baby and prevent tearing as the baby is delivered during childbirth. Many women are requesting that episiotomies not be done routinely, and some doctors are willing to comply – as long as the health of the baby or its mother isn’t placed in jeopardy by not doing an episiotomy.
Often the doctor will inject anesthetic to numb the area before performing an episiotomy if the new mother has not had an epidural or other form of anesthetic – but not always. Most doctors believe that the pressure from the baby’s head on the area provides a natural anesthetic, but it doesn’t completely numb the area. After the baby and placenta are delivered, the doctor will stitch up the episiotomy, again with or without the benefit of anesthesia.
Episiotomies increase the amount of time it takes to heal and make sitting and moving around more uncomfortable. Usually new mothers will get an irrigation bottle to rinse their stitches with warm salt water. This speeds healing and makes the area feel better. Many women are afraid to use the bathroom after having an episiotomy for fear of tearing the stitches, but this is unlikely.
If you want to avoid an episiotomy, you must first make sure your doctor is aware of your wishes. Tell your doctor at several of your prenatal appointments that you want to avoid an episiotomy if at all possible. You will also need to remind your doctor and your nurse when you arrive at the hospital to give birth. If you have a birth plan, make sure it is listed and highlighted, and give a copy to your nurse and doctor at the hospital.
If you want to avoid an episiotomy during the birth of your child, you should stay healthy. Eat right and exercise to keep your weight down and your muscles toned. Ask your doctor for some recommended pregnancy exercises and meal plans if you’re unsure. You should also work on your kegel exercises during your pregnancy. This is an exercise that strengthens and tones the pelvic floor, which can make childbirth easier, speed healing time, and help get your body back into shape after giving birth. The best thing about kegels is that you can do them anywhere. If you’re sitting at your desk at work, watching television, or even resting in bed, you can do kegels and no one will even know. Your doctor or nurse can give you instructions on how to do kegels.
When I had my first child, the doctor performed an episiotomy. At the time, I believed it was standard practice (it more or less was), and I didn’t know that I could try to avoid it. By the time I had my second child, almost five years later, I knew that it may be possible to give birth without having an episiotomy. I asked my doctor during one of my regular office visits, and he said he would try to avoid it if possible. As it turned out, my doctor couldn’t deliver my baby. One of his colleagues stepped in, and I didn’t even think about the episiotomy until by baby was crowning. As I sat up to push, I blurted out, “Can you please not do an episiotomy?” She said she would try as long as I didn’t start to tear.
As it turned out, I didn’t have to have an episiotomy with that childbirth or my next one when my daughter was born. I was glad that I voiced my concerns and my wishes and avoided this painful procedure and extended recovery.
