Episiotomy or perineal tearing (ep. 27)

Episiotomy or perineal tearing (ep. 27)

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2:54 min| 78,841 views

Learn about surgical and natural tearing during labor and what's involved with healing.

Source: Childbirth Connection, a nonprofit organization dedicated to improving the quality of maternity care.

Prepare for labor and delivery with our online birth class. See all 51 videos in this series.

Show transcript

Linda Murray: An episiotomy is a surgical cut in the perineum, the area between your vagina and anus, to enlarge your vaginal opening for delivery. It can be helpful or even necessary if your baby needs to get out of the birth canal quickly or if your doctor or midwife needs more room to pull your baby out. If you're not already numb, you'll get a shot of local anesthetic before the procedure and again after your baby is born so you don't feel it when you're stitched up. While inductions and c-sections are on the rise, episiotomies are becoming less common.

Doctors used to think than episiotomy would help reduce a woman's risk of having a serious vaginal tear during delivery or ending up incontinent, unable to control her urination and bowel movements. But research over the past couple of decades has shown that an episiotomy may not help with these things and can actually cause problems. It can also make recovery longer and more painful than it would be after a natural tear. That's why most experts now say that episiotomies should happen only when they're needed to help deliver your baby safely, not as a matter of routine. If you have concerns or questions about episiotomies, bring them up ahead of time with your doctor or midwife. The best protection against an episiotomy is a caregiver who tries to avoid them.

Jeanette Lager: So during labor, the ways to reduce tearing is to listen to your practitioner while you're pushing and in part, they will help you to time your pushing. Sometimes a controlled push, especially towards the end of labor, will help to reduce tearing. It gives the infant’s head a chance to press down on that area, stretch it on its own naturally, and then you can slowly push out the baby, and that will give your perineum a chance to stretch and relax and hopefully reduce injury as well.

Mom 1: I had the pleasure of having an episiotomy, it was probably the most painful aspect of the post-birth experience.

Mom 2: [They] put a few stitches in there, and it made the process of healing a tiny bit different, but all in all, I don't think my healing process was any different than anyone who didn't tear.

Mom 3: They went for the episiotomy thinking it was the quickest way to get him out, and I appreciate that and everything, and stitches—all of it was great at the time of and the first few days were great, but I actually ended up getting 2 different infections, so it took almost 4 months total to heal.

Mom 4: I had 2 to 3 stitches, I think the doctor told me, and it was pretty painful walking around after birth, and it took at least a week for me to be able to walk comfortably.

Mom 5: I wish I had known to take it easy in the pushing because, as a result of the tears, I had a really long recovery time.

Watch the video: How to do and Repair an Episiotomy. Merck Manual Professional Version (June 2022).


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