Hello again,
I'm curious if anyone (especially midwives) has experience with women who have had previous episiotomies. I'm wondering if the scarring causes a greater likelihood of tearing in a subsequent birth with no episiotomy. I have had two previous mediolateral (s?) episiotomies (virtually in teh same spot) and would like to deliver with an intact perineum next time. Anything I can do to soften that scar or should I just leave it alone? Am I more likely to tear than someone without a scar?
Thanks,
Robsgirl
April Bailey
Moderator
Robsgirl,
have had many mamas with previous epis scars go on and birth over a completely intact perineum. Good nutrition and hydration during pregnancy coupled with mama led pushing in a more upright position will all help. Have had 3 mamas with previous 4th degree tears go on and birth without even a skid mark.
blessings,
April
vada
New Member
Hi,
when pregn. with my second I heard that women would tear more easily in the spot where the scar is, so I was scared my episiotomy scar would brake open. But of course that didn't happen
My episiotomiy was midline and extended into a 4th dergree tear. With my second I had only 1 little tear that needed just two stiches and a tiny skid mark.
I also have friends with previous epis and they had no tear and no skid mark, so totally intact. So it is possible not to tear, but if you did tear it probably would be only very little.
~Lysan~
lucky mum to my precious boys Lio *Oct 21 2003* and Amoz *June 15 2005*
Yabba Dadda Doula
Starting Member
Try using Vitamin E oil during perinium massage. Causes greater elastisity.
Brlnbabies
Moderator
Yabba Dadda Doula, what's your experience with this? My thoughts are to leave the perineum alone--don't mess with it, don't massage it, just leave it be. I see more tissue breakdown and swelling when people are always messing with the perineum.
Doulamary
Advanced Member
I agree with Brinbabies...leave it alone...seen plenty of births where nothing is "done" and mom remains intact.
Mary
RobsGirl
Junior Member
Brlnbabies,
Would you recommend not doing any perineal massage during the last weeks of pregnancy or are you only referring to refraining from touching the perineum during second stage? Just looking for that clarification?
Robsgirl
Brlnbabies
Moderator
My advice to anyone who asks me is to leave the perineum alone. The perineum is designed to stretch beautifully or to help itself out when needed. There is a school of thought that massaging the perineum several days or weeks before birth helps women stretch and/or it helps them cope with the "ring of fire" during crowning. I still say leave the perineum alone. All that stretching and pulling causes a lot of swelling and the tissue starts to break down. Then you have more breakdown during the birth.
The best thing to help a woman stretch and keep her peineum intact is to let her find the best position during pushing. No woman left to her own devices is going to lie on her back and grab her legs back under the knees. Nor is she going to hold her breath for long periods of time. She'll push as long as she wants and she'll assume the most comfortable position. When she feels the baby crowning, she'll most likely naturally put her hand on the head and control her efforts all by herself. In my opinion, it's when women are told to do it a certain way is when they get their poor perineums in trouble.
RobsGirl
Junior Member
Thank you Brlnbabies,
I totally hear you and I agree. I felt strange being basically strapped to the bed (by the stupid IV and monitor) on my back and holding my breath for 10 counts. It all felt so wrong. I really love my OB, but more on a personal level. He's always so interested in our lives (several women from our church go to him) and really likes our families etc. So he's a great person, but very non-informative, and when it comes down to the delivery in the hospital, it's all hospital protocol and not woman-centered. I have found a midwife who delivers in a hospital birthing center (for natural births only) and she is very non-interventive and woman-centered in her care. CS rate is 5%, episiotomies are very rare (she can't remember the last time she did one), and she doens't push all the prenatal testing, leaving it up to the woman. She has 30 years under her belt and she takes my insurance. Though I'm yet to use her for any services, I feel blessed to have found her. There are a few homebirth midwives in my are, but according to them, my insurance company is difficult to deal with when it comes to getting paid for homebirths.
Thanks,
Robsgirl
Mom2B
Senior Member
Labor in water, softens it right up! I didn't have any "ring of fire" upright in the water, directing it myself. Even birthed both shoulders at once. No tears.