Labor Tearing Vs. Cutting
Most expectant mothers wonder whether or not they should try to avoid an episiotomy. On the one hand, they've heard that an episiotomy prevents vaginal tears and, on the other hand, recent research seems to suggest that tears may heal faster and better than an episiotomy incision. It can be difficult to know what to believe.
There is a technique that can be performed that can prevent tears and reduce the chances that you'll need an episiotomy. This technique is called perineal massage. The condition of your skin is also a factor so be strict about maintaining a proper diet so as to prevent iron levels from dipping which can lead to anemia. Keeping your weight in check can also make a difference. The more you gain, the more the baby gains. Think: small hole, big fat baby, and you'll understand why not gaining too much weight can improve your chances of giving birth while keeping your perineum intact.
Many experts believe that epidural use is a biggie in causing the need for episiotomy since it robs you of your ability to work with your birth attendants during the pushing stage of the delivery. Epidurals may also lead to a need for vacuum and forceps deliveries which generally require an episiotomy to be performed.
Listening well to your birth attendants can help prevent lacerations. Small, controlled pushes are what is needed. Once in a while, a mother will be asked to push between the contractions in order to better control the force of the pushes.
If lacerations do occur, they are usually small and don't extend to the muscle. But when an episiotomy is performed, many layers of tissue as well as muscle are cut. Usually, lacerations only affect superficial tissue.
Lacerations are not as uncomfortable as episiotomies while healing. Perhaps this is due to the fact that a natural laceration follows the woman's own anatomical lines. Also, the scissors used during an episiotomy crush the tissue in a way that a tear cannot.
In some cases, an episiotomy should always be performed. In general, this is done when the baby is in distress, or a serious tear that would affect muscle or rectal tissue seems inevitable. It's important to note that the risk of rectal and sphincter lacerations is highest for those who undergo the episiotomy procedure.
There are a great many factors to consider when deciding whether or not an episiotomy is necessary. Perhaps the smartest way to handle this decision is to choose a health care provider who is willing to listen to you, work with you, and ideally, agrees that an episiotomy is not necessarily a routine medical procedure.
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