From: sander@cwi.nl (Sander Plomp)
Newsgroups: misc.kids
Subject: Re: Episotomy...What my doctor said...Is this true? Anyone NOT have one?
Date: 17 Nov 92 12:58:44 GMT

oispeggy@ubvmsd.cc.buffalo.edu (Peggy Brown) writes:

[ ... deleted a bit about a doctor described rather accurately by:
>I think his idea of his role and patient rights is very outdated.
  ... ]

>We discussed episiotomy for awhile.  He said that in most 
>deliveries and nearly all first deliveries it must be done.  I 
>pointed out that in other countries and in home labors they are 
>not done nearly as often. I said that I did not want any muscles 
>cut.  He said that even without an episiotomy, the muscles are 
>often damaged (sometimes to the point of breaking).  According to 
>him, even if there is no tear there are invisible injuries to the 
>muscles that will not heal as well as an episiotomy. Thus a woman 
>can avoid an episiotomy and end up with weaker perineum muscles than 
>she would have had if she had an episiotomy.  Does this make 
>sense to anyone??????  Didn't make any sense to me.

What he claims is that without some surgery nearly all women are
severly injured in child birth. Has he never wondered how mankind
made it into the twentieth century without his help? I know things
can go pretty wrong, but not that this happens with "nearly all
first deliveries".

I have heard both claims that episiotomies heal better/faster/easier
than tears, and claims the other way around. I don't know what is
true in general, but my wife ended up with both and she claimed
the tear healed faster. But that's just one datapoint. A episiotomy
is probably easier to stitch though, which might make doctors think
it's a less severe wound.

>                                                     Plus I've 
>read that an episiotomy can tear even further than the actual 
>incision, like through the rectum.  Sounds to me like starting a 
>tear in a piece of clothe.  Once its started, rrrrriiiiiippp!

I think the idea is that with an epistiotomy one can chose the
place such that if it tears any further the tear will go in a
"safe" direction. But I agree with you that creating a weak
spot before any tearing has started is not a good idea.

>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?  

He's probably wrong. My wife developed a tear which treathened to
go towards the rectum. Since it's nasty if a tear goes all the
way there the midwife simply pushed back the baby a bit and did
an episiotomy to divert it. So a tear does not have to happen
all at once.

[ ... deleted a bit more to save bandwidth ...]

>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?

I doubt his information is accurate. Mayby not scare technique but
he simply learned that episiotomy is needed and has always done
them and cannot imagine one could go without. I found out that
becoming a parent is an effective way of loosing trust in the
compentence of the medical establishment.

I hope you get someone more cooperative when it happens.
-- 
Sander Plomp                                    Internet: Sander.Plomp@cwi.nl
Newsgroups: misc.kids