From: dhardin@bbn.com (Dawn Hardin)
Newsgroups: misc.kids
Subject: Re: Episotomy...What my doctor said...Is this true?  Anyone NOT have one?
Date: 12 Nov 92 17:31:21 GMT
NNTP-Posting-Host: bbn.com

In article <BxK9r8.7wr@acsu.buffalo.edu>, oispeggy@ubvmsd.cc.buffalo.edu (Peggy Brown) writes:
> 
> He has a very authoritarian/paternalistic attitude and makes 
> comments to the effect that its UP TO THE PHYSICIAN WHETHER OR 
> NOT AN EPISIOTOMY IS DONE.  I of course nicely told him that since 
> it is my body it is up to me to decide whether or not an episiotomy 
> or anything else will be done.  I don't think he was listening.  
> I suspect he figures I'll be in sufficient pain that I will accept 
> anything he does without questioning it.  (Pain has a way of making 
> people submissive.)

What is it about childbirth that attracts such nazis?  I went to a group
of 4 midwives.  One of them told me that she wouldn't give me painkillers
if I asked for them because I'd only regret it later.  Luckily, the other
three were sensible and said the decisions were mine.  I was lucky --
I not only *didn't* get the nazi, it was my favorite on duty when I went in.
And I didn't ask for painkillers until 30 seconds before Alice was delivered.
The midwife was just about to give me a local when the baby popped out.
She barely had enough warning to drop the needle and catch the baby.

> I also said that would not want an episiotomy automatically done. 
> Instead I would want to wait and see if a tear started.  If it 
> started and got to a certain size, then I'd consider an 
> episiotomy.  He said that tears do not develop gradually.  They 
> happen all at once, so unless you have an episiotomy ahead of 
> time forget it - the tear will happen so fast it will be too late 
> to do anything.  This makes no sense to me either.  I mean, 
> doesn't it tear bit by bit with each contraction?  

I tore at the last minute, right when Alice came out.  This may have been
because the midwife had turned away to prepare the local and was caught
by surprise.  She might have been able to prevent it if she realized that
one more push was going to do it.  There definately would have been no 
time to do an episiotomy.  She was considering giving me one because I
had been pushing for two hours and I was getting sore and discouraged,
and she thought it would speed things up.  The tear was smallish.  She said
she was going to give me two stitches, but I think she really gave me
three or four.  It was certainly the worst part of the whole thing.  I
didn't feel the tear at all and was surprised when she told me, but the
stitches were pretty bad.

> As I said, I hope this guy doesn't deliver my baby.  I can tell 
> already we will have some big problems regarding who is in 
> control, regarding the episiotomy and anything else that comes 
> up.  Its unfortunate to have to anticipate working with a 
> doctor who is NOT supportive about what the patient wants and not 
> willing to try perineal massage, and work with the patient to 
> avoid an episiotomy.  My chances of having what I consider to be 
> a good birth experience are low if I have to work with this 
> doctor who does not support my preferences.

Please don't judge your birth experience solely by the episiotomy,
or the doctor.  It's far from the most important aspect.  Also, I wouldn't 
be quite so optimistic about the perineal massage.  I thought it hurt a lot to
get touched there while I was pushing.  I didn't let her do it much.

> How accurate was his information, or is this a scare technique?  
> Also, anyone have any statistics on episiotomy and homebirths or 
> births in other countries with lower rates?

If I remember correctly, Ima Mae Gaskin's _Spiritual Midwifery_ contains
a table of stats.  If no one else posts anything, I'll (eventually!)
look it up at home.  I think it comes from the 70's/early 80's, though.
The gist was that tears were slightly up, but something like 80% (?)
got through with no tears *or* epsiotomy.

The stat I would have liked to have seen is something like inches torn +
inches cut for the epsiotomy crowd vs. the no episiotomies, but maybe that's
not the appropriate one either.

> Anyone out there ever NOT have an episiotomy?  If so, how are 
> your perineum muscles?  Did they get damaged as my doctor 
> described?

My perineum muscles are not what they used to be, but since I can't 
say what they'd be like if I had the episiotomy, that doesn't really mean
anything.  Also, they still seem to be improving (a year later), so maybe
it's more a question of muscle tone than it is a question of damage.

Dawn
"Hello death, goodbye Avenue A.  I'm getting tired of waiting, tired of
being afraid.  Joseph Campbell gave me hope and now I have been saved.
So I sing hello death, goodbye Avenue A."  "Folk Song" by Bongwater.
From: kperdue@hpsmtc1.cup.hp.com (Karla Perdue)
Date: Tue, 10 Nov 1992 18:56:15 GMT
Subject: Re: parent/child relationships
Organization: Hewlett Packard, Cupertino