Episiotomy and perineal massage

Childbirth prep class attended today!

After not watching "A Baby Story" (reality TV shows of birth experience) for a while, I was (again) all teary watching birthing process video of several moms. It hits me again, parturition is a pain-enduring experience and it is scary!  I am scared, yes, but the truth is I am more nervous to the future prospect of handling a new tiny little creature (which is not a cat). Pain is pain, they will go away. I am talking about taking care of another human being. Oh my.. definitely there is no turning back (haha!) at this point of time. Hopefully I will be as strong as you, yeah you, all the mommies out there! 

Anyway, after learning all the different breathing techniques, the advantages and disadvantages of C-section, epidural, and many more, the only thing that sticks in my mind : labor is not a one-person job, it is a two-person job (or more if you wish). What I know right now is I need Jai to be by my side all the time, during the labor, giving me all the support and motivation when I need them, whispering to me every now and then : "You can do this" as I know I can easily lose my concentration especially when I am in pain. Although I do not know if he gave his full attention during the class today (as he only slept for 4 hours due to work), but all I know he will be there with me, he will guide me until our daughter is finally in my arms. Ok, tibe2 rasa nak nangis. 

Now I know how my mother must have felt. No wonder she said she has easy labor experience with all of us cos Allah knows the best.

Ok, back to the title. I have promised to write something about episiotomy. As what I have been told, both by the midwives and in childbirth class today, episiotomy is not a routine procedure in most hospitals in the US. Yes, you will tear especially when you are a first-time mother, but there is something you can do to minimize having an excessive tear. It is called a perineal massage. It helps to soften your perineal muscle so it reduce the possibility of excessive tear or needing episiotomy. It is generally done 6 weeks before your due date and you could ask your partner to help if you are not comfortable doing it yourself (you know with your big belly and concurrent back pain, it is uncomfortable).

How to do it?

I have not started doing it, not yet. But I like to share with you this link which is the same leaflet provided to me by my midwife.

Click HERE.

So, according to several research articles I read, episiotomy is unnecessary unless you are having speedy second stage labor in which baby needs to come out fast. Having said that, other than perineal massage, a slow labor process also helps to reduce tear and the need of episiotomy. 50% of women who had vaginal birth do not require episiotomy and if routine episiotomy is still performed, they provide a greater injury as a result of the surgical incisions made. Episiotomy is also one of the risk factors of having anal sphincter (anal muscle that control your bowel movement) lacerations. The healing process is also faster in women that had no episiotomy.

Note:
The paragraph above were summarized from these following articles:

The Risks and Benefits of Episiotomy: A Review. Banta et al., 1982.

Outcomes of Routine Episiotomy. Hartmann et al., 2005.

Episiotomy Use in the United States, 1979–1997, Weber et al., 2002.

Episiotomy in the United States: has anything changed? Frankman et al., 2008.


Hopefully we could all benefit from applying perineal massage before labor so that episiotomy could be avoided in the future. Happy trying =)