Episiotomies and Epidurals

My apologies to all my Hypnobirthing readers for not posting anything for quite some time. I have been quite busy with the stay-at-home-mom thing, maybe even more so that when I was working part time! By the way, if you are a faithful Hypnobirthing reader, please feel free to leave a comment and let me know. That will encourage me to write more posts about it!

As you can tell from the title, today I wanted to write my feelings about two common interventions in childbirth today: Episiotomies and Epidurals. First–episiotomy. One of my greatest concerns in preparing for childbirth was having to have an episiotomy. I have heard from many women that healing from these cuts can take months and be very painful. I had also heard that many class 4 or 5 tears begin with an episiotomy. (If you don’t know what the classes are, basically 1 is a minimal tear, and 5 is a complete tear from vagina to anus. Sorry to be so graphic!) I was told from my hypnobirthing instructor that the skin of the perineum is like fabric…if you just try to tear it on its own, it is very strong and resistant, but if you cut a little snip in it first and then tear, it will easily tear right through. Makes sense to me. The little “snip” is an episiotomy.

What I feared most was that my baby would be so big that an episiotomy would be unavoidable. I was 9 lb. 8 oz. and Nathan was 9 lb. 10 oz., so I was sure, with a 6-day-overdue baby, that she would be at LEAST 9 lb. I asked my hypnobirthing instructor if it was even possible to deliver a 9 + pound baby over an intact perineum. To my surprise, she said that is was and she had personally attended births were this was the case. Both she and my midwives encouraged me to practice perineal massage during the last 4 to 6 months of pregnancy. Nathan and I were pretty good about doing this regularly (thought often not happily!) and I feel that we achieved the desired result. Kaisa, though not 9 pounds, was a big baby. I did feel quite a bit of pain as she was crowning, and I had two small tears. The interesting thing is that I tore in an upward direction. Perineal massage was performed in a downward direction. I think with the next one we will massage in every direction. :) My midwife was also wonderful in helping avoid cutting. She and Nathan were both working on the area, massaging and applying warm compresses as Kaisa was coming down.

Another common myth about episiotomies is that they heal more cleanly than a tear because they are a clean cut. Thanks again to Monica, I learned that tears actually heal better because the uneven edges create a more complete heal, one that is LESS LIKELY to reopen at subsequent births. Monica received an episiotomy at her first birth, and tore along the SAME LOCATION at her next one. Coincidence? I think not.

So…here’s the point. Ladies, this painful and unnecessary procedure can be avoided! It is better to have a small tear than an episiotomy. Talk to you care provider about your feelings, do your perineal massage, and learn to relax that area so you can do so during childbirth (hypnobirthing really helps with that) and you can deliver your baby without an episiotomy! You will have a much better birthing experience and heal much faster.

Second–epidural. I have to admit, when I watch A Baby Story on TLC and see a woman before and after her epidural, it does look inviting. But I have personally spoken with several women who have done it both ways, and the general consensus it that they preferred birthing their babies without! Why, you ask? The number one reason was because they healed much faster. When I thought about it, this made perfect sense. When you push a baby out without feeling what is going on, you are probably going to push way too hard. You’re not going to feel your body’s natural waves and be able to go with them. You will most likely cause severe trauma to the perineal area, not being able to feel “the ring of fire” and as a result not slowing your pushing enough to allow the area to stretch. When others are coaching your pushes, you are robbing your body of the ability to birth in its own, natural way.

I do believe that epidural can be beneficial to some women. Those who have severe back labor, extremely long labors, or who have not educated themselves about childbirth and comfort techniques during labor should probably have the epidural. However, there are some excellent alternatives that provided me a lot of comfort during the most intense part of labor. First, the tub. I got in and out of the tub three times during my labor. The warm water and jet blowers were almost like a natural epidural…I felt immediate relief. Second, a birthing ball relieves so much of the pressure during contractions. I spent a great deal of my labor sitting on the ball. Third, light tough massage from your spouse or birthing companion can release endorphins, releasing tension and easing pain. Fourth, comforting and relaxing music. Having music in the background helped me forget about the pain and relax my body so it could do its job unimpeded. If you want to birth your baby without an epidural, the number one thing you should do is write in your Birth Preferences that you do not want to be offered one. I think if a nurse had casually come up and mentioned that the anesthesiologist was right outside the door and could quickly set me up with an epidural while I was in intense labor, I probably would have said yes. Thankfully, they honored my request not to offer pain medication, and my wonderful husband and midwife helped me through the worst part so that I was able to have the natural birth I wanted. I am so grateful I did it. I had an alert, happy baby and healed very quickly.

What are your feelings on these interventions?

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