From: pburch@bcm.tmc.edu (Paula Burch)
Newsgroups: misc.kids
Subject: Re: Pregnancy and episomity
Date: 18 Nov 1992 16:46:50 GMT
Organization: Baylor College of Medicine, Houston, Tx
Distribution: world
Reply-To: pburch@bcm.tmc.edu (Paula Burch)
NNTP-Posting-Host: roc.mbcr.bcm.tmc.edu
Originator: pburch@roc.mbcr.bcm.tmc.edu


In article <17NOV199216304560@vstn1.math.uoknor.edu>, 
smudd@vstn1.math.uoknor.edu (stephanie) writes: 
|> ....I have been reading all the posts on episomities and am
|> getting a little scared.  When my mother had my sister and I, she didn't
|> dialate all the way to 10 (not sure what she did dialate to) and had us just
|> fine.  Although I don't know if she had an episomity or not, she doesn't talk
|> much about it.  When my grandmother (my mom's mom) had her she did not have an 
|> eposimity and she riped to her rectum.  If you have a episomity what is life
|> like after you are healed?  Can you still have sex and will it be like before
|> you had the baby?  I know these questions may sound silly, but I am very
|> anxious to know everything I can about these things.  

I can't give any personal perspective on episiotomies, since I had a 
c-section (and I'd be too embarrassed to give details of my own epis. over 
the net if I *had* had one :-), but an acquaintance of mine says that sex is 
better now, although she had an episiotomy.

She says that in her drugged state, after the baby was born, she told the 
doctor who was sewing her up not to take in any extra stitches, she didn't 
need it any tighter, thanks. One does read horror stories of doctors 
deciding to do the husband a 'favor' and making it tighter than before--
some favor, to have your wife find sex painful, eh? The doctor didn't know 
*what* she was talking about, though. The nurse told him, "I know what 
she's talking about, and you don't do it, so don't worry about it."

Anyway, she says her episiotomy was bearable and now sex is actually more 
comfortable than before. Evidently a little bit of stretching from 
childbirth can be a good thing, and the episiotomy didn't bother her 
much at all. You really shouldn't be very afraid of the chance that 
you'll have one--it's not the end of the world if you do. Take steps 
to avoid one now--such as changing doctors, if necessary--but don't 
expend too much dread on the idea.

I still hope I don't ever have one. Studies show that episiotomies 
increase the risk of tearing, and increase the degree of tearing. (I *wish* 
I hadn't lost the reference to that last definitive study--it was in the 
newspapers.) Ripping down to the rectum is much more likely with an episiotomy
than without one. If you want to avoid ripping, far more effective than an 
episiotomy would be:

1) Practice perineal massage (I still have the file on this that Laura 
Watson posted last year)

2) Avoid the use of stirrups--these drastically increase the risk of a 
bad tear

3) Try alternative pushing positions, such as squatting--practice this now

and most importantly--

4) Get a midwife or OB who coaches you in not pushing too hard right before 
the baby's head comes out, and supports the area with her hands at the 
right time.

Paula Burch
pburch@bcm.tmc.edu
Newsgroups: misc.kids