Episiotomies. I hate to even think about them. *Shudder*
I started this post planning on only writing about episiotomies, but it’s so hard to just stick to this one topic when it is affected by so many others.
Did you know that when you lie down to give birth your pelvic opening is much smaller than when you are standing? Also, the lithotomy position (on your back) causes more pressure on your pelvis and vaginal opening. So, sometimes a episiotomy may seem necessary to your doctor, when in reality if you could get up and let gravity do its thing, you could, in all probability, give birth without even tearing! If you think about the shape of your birth canal, you’ll realize that it’s in the shape of a J. When you are lying down, you actually have to push the baby UPWARD to get it out. Take this fact along with the fact that your pelvic plane is smaller lying down and you’ll quickly come to the “stuck baby” conclusion.
Another thing that can affect your chance of getting an episiotomy is “purple pushing” or coached pushing. By pushing when your body tells you too, or even better, letting your body do most of the pushing for you, you can reduce the pressure on your perineum, which in turn reduces the risk of tearing or of “needing” an episiotomy. Also, not purple pushing lets your tissues stretch gently to accommodate your baby’s head. If you are pushing forcefully when your body isn’t ready, you risk pushing the baby out too fast so that your body doesn’t have time to stretch and then risk tearing.
Sometimes episiotomies can lead to even worse tearing. The best analogy I have ever heard was that your perineum is like a bed sheet. If you make a cut on the edge of the sheet and then put pressure on it, it rips easily. If there is a small tear in the middle of the sheet and pressure is exerted on the sheet, it is much less likely to tear anymore. The vaginal tissue is the same. If you cut an episiotomy into the perineum, the baby’s head coming through the birth canal is much more likely to rip your vagina even more than if you tore a little bit in the middle of the tissues. Did you know that a tear heals faster than an episiotomy? Also, a small tear does less damage to your pelvic floor (important for avoiding urinary incontinence and sexual pain/discomfort). AND your body won’t tear unless it needs too.
**Combine upright positions, undirected pushing and a GREAT care provider to avoid unnecessary genital mutilation.**
Letting your body do what it is MADE TO DO (birth babies) is the best option – for your safety and your baby’s safety.
Pushed Birth: But My Vagina