Friday, February 21, 2014

Episiotomy

What is an episiotomy?

An episiotomy is when a cut is made in the perineum. There are 2 types: median and midline.
Midline is a cut made straight down the middle of the perineum.
Median is made at an angle to the right or left.

Are episiotomies necessary?

Generally speaking they are not necessary. Some providers use them as an alternative to tearing.
In the case of a emergent situation they can be necessary. For example, the baby is almost out at the vaginal opening, but the heart rate is dropping drastically. An episiotomy may be performed to help the baby get out quickly instead of doing a c-section.

Is an episiotomy better than tearing?

This question is clearly up for debate and you can find research supporting both views. From my personal understanding and experience I believe it is better to tear for healing purposes. The reason for this is it's a natural process and the tear fits back together upon repair like a puzzle. When there is a clean cut this does not happen. Also, with a cut it becomes easier to rip like when you cut a piece of paper.

Have you had an episiotomy? What are your thoughts on them?

2 comments:

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  2. A visual for you: Put your two hands together, side by side, so your index fingers touch (your thumbs are at your palm, like you're signaling "4" - and not in prayer hands, just side by side). If you separate your hands now, that would be like an episiotomy - easy to put back together, right? Now, imagine a tear, sewn back up - interlace your fingers. Which one is easier to pull apart? So, one argument is that tears are far "superior," because they're stronger once healed. That said, you can "re-tear" along the same line in a future delivery. Another thought to add to episiotomy: just because the doctor performs one doesn't necessarily mean you won't tear. You can still tear, even past the episiotomy. And that can be really bad!

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