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Syncletica
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| Posted: Sept 26 2007 at 5:14pm | IP Logged
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Well, I'm due in about 3 weeks. Do any of you ladies have suggestions for ways to avoid episiotomies and tears? I'm aware of the massage. Would like other ideas.
Thanks!
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JodieLyn
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| Posted: Sept 26 2007 at 5:46pm | IP Logged
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get upright.. any time you sit, whether reclining or not, you are limiting how much that side can stretch/move and putting more pressure opposite.
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JamieM
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| Posted: Sept 29 2007 at 1:34pm | IP Logged
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Hey, I know you! It's JamieM from RGT.
With my last pregnancy, I decided to forego the episiotomy even though I had scar tissue from having had two episiotomies in the past. I heard massaging the area with olive oil, or wearing an olive oil "pack" would soften the area. I could NEVER get the hang of massage, so I didn't do it. From what I've heard, the two big factors that affect stretching are 1) your diet (should be heavy in good animal fats so your skin is softer) and 2)the position you push in. I ended up side-pushing and FAST and did end up with some second-degree tears. But they healed quickly and caused hardly any pain. HTH
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Lisbet
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| Posted: Sept 29 2007 at 5:07pm | IP Logged
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Birthing in water helps, but if that is not an option hot compresses encourage good blood flow at the time of birth, reducing the risks of tearing. Birthing position, as mentioned above, makes a big difference also. Squat squat squat! 
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esperanza
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| Posted: Sept 29 2007 at 6:17pm | IP Logged
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Just to add to the above advice...
I think having a skilled person catching the baby is important. My first two were born in a military hospital 22 and 19 years ago...episiotomies were routine. I was concerned about tearing with scar tissue for my third ...my next three were home births and three different positions...my babies kept getting bigger until they hit 9 1/2 lbs with two shoulder dystocias and miraculously no tears!! I think it was the midwives (they used hot compresses) and doctors supporting the area...for my experiences. Oh yeah and my favorite birthing position was side lying..I was easily able to "not push" when told, while letting things stretch more slowly.
What # baby is this for you?
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nissag
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| Posted: Oct 10 2007 at 2:33pm | IP Logged
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I second being upright and compresses. My midwives use chamomile compresses all through active labor. If you do get a tear, goldenseal may fix you right up - it worked beautifully for me.
Also, really opening up and trying not to push too hard (easier said then done!) is good.
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CAgirl4God
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| Posted: Oct 10 2007 at 6:59pm | IP Logged
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I have four tears.... and then with number five... nothing!
I too did side birth, with the doc massaging the area with something warm. now that I think about it, I have no idea what she used! lol. but it worked. no tears at all.
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Syncletica
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| Posted: Oct 10 2007 at 7:52pm | IP Logged
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Thanks ladies!
Hi Jamie! Nice to 'see' you again! 
Esperanza - This is baby number 5. And I'm due in a week. Babies #2 - 4 have been 4-6 days early, so I'm expecting to go in anytime now. God's Will be done. My husband is out of town and won't be coming back until I call him to let him know I'm in labour. He'll probably miss the birth, b/c baby #2 was 1 1/2 hrs, #3 was 6 hrs, but born in the car, and #4 was 4 hrs. Be interesting to see what happens. We live in town and are not too far from the hospital, so hopefully I'll be in a somewhat good enough condition to drive myself.
I got an episiotomy with my first who was delivered by the emergency doctor. (Only #4 was delivered by the actual doctor). I believe I got very slight tears for the others. Nothing like the episiotomy. The nurse told me that had it been her, she would not have given me the episiotomy.
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Lillian
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| Posted: Oct 11 2007 at 12:29am | IP Logged
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Well, I tore with my first two and didn't tear with my last three. The last three were with midwives. What they did differently from the doctors was to encourage me to push slowly. The hospitals kept telling me to "Push, push, push." Their goal was to get baby out quickly. And so when baby comes out as fast as a cannonball its no surprise that tearing happens.
The midwives really encouraged me to go slow or even stop sometimes. They would also watch and tell me when to push and when to slow down. So I second the advice of trying to have a good catcher.
Hope that helps. I also did alot of stretching exercises as suggested in this book. This book was also helpful. Sitting criss/cross on the floor instead of the comfortable sofa is better for stretching. And doing lots of squatting. I've never had any massaging or compresses done.
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Syncletica
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| Posted: Oct 11 2007 at 10:57pm | IP Logged
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I have another question - isn't side-lying very awkward? I've never tried, don't know if I've even read about it. Is someone holding up one leg?
As for good catchers, I'd much prefer a mid-wife, but we are the only province in Canada that still has to pay for them. Going to the hospital is free. Mind you, I can't really complain about any of my hospital births either.
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Nina Murphy
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| Posted: Oct 11 2007 at 11:27pm | IP Logged
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I will jump in just to give my own personal experience, Syncletica, although others may feel quite differently.
You asked about side-lying and I will be very honest and say my most frightening and painful pushing/crowningn was when I insisted on trying the side-lying because I had heard/read so much about the traditional position not being the best for comfort, control, etc.
Perhaps it was pyschological and I tensed up, but there was a feeling of being out of control and not knowing what was going on and not "seeing" and being at the mercy of the persons holding up my leg, etc. It also felt more humiliating/violating, for some reason.
I do not want to turn you off from it unnecessarily; I am just sharing my experience.
I think we need to go with our instincts and my instinct is to be on my backside, flat down, with my head up, semi-sitting. It has been the most discreet/modest for me. (I know. Huh????) Yet, so much of it is how relaxed/comfortable we *feel*.
I have only had one episiotomy, with my first. I do make sure to get enough Vit. E and EFAs incl. the flaxseed/Omega 3/healthy oils in my diet, as well as Vit. A and C. After all, we are dealing with skin and it's elasticity. Much is genetic. And I am convinced so much is size of baby, which Mom can not control---and shouldn't!
Hope all goes well!
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Chari
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| Posted: Oct 12 2007 at 11:47am | IP Logged
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I am sorry, Nina, for your frightening experience. I think you are right, it may be psychological. I had a similar problem pushing out my fifth, doing it someone else's way.........HER preference. I felt totally out of control. As soon as I said: I want to push in the same position as last time (on knees on floor, upper body leaning over bed) the doctor let me go.......and all was well.....and he was born two pushes later.
This just shows how important it is to LISTEN to what your body is telling you. Be where it feels best for YOU.
As for the side-lying position, I would say at least 50% of our patients in the last ten yrs have delivered side-lying (I am on OB RN). It works well enough, because you can get that top leg high and back. I would venture to guess the pelvic diameter is slightly larger side lying than in the C position because of that. It is a good position for tired mommies. During pushing contractions, someone holds the top leg up.......and I PREFER someone supports the other leg (I think it works better, but I do not always see it done.). Between contractions, the lg goes down to rest.
In my experience, the best way to prevent a tear, is to have someone massaging the perineum during pushing. It really helps to prevent tears. (That said, ALL of what was written above, put together would be BEST scenario.........just not always available for all women all the time).
Of course, when you have fast labors (I WELL know the scenario X6  ), there is not much chance sometimes for choosing your position, or for perineal massage.
I pray for you a blessed and lovely labor!
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Nina Murphy
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Chari, I didn't know you were an OB RN! Will you come deliver my baby!!!!? I WANT you!
Oh, yes, I am sure you are right. I was really scared and tense during that one, even with being in the water up until the end---but my Magdalene Therese is the opposite, a totally relaxed, laid-back sweet angel! She was worth every moment. (I think I needed to do some penance and was offering it up "beforehand"....God took me at my word.
I just like being able to see what's going on. I think a C-section would really freak me out!
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nissag
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| Posted: Oct 12 2007 at 12:19pm | IP Logged
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Chari,
You are so right about listening to your own body - it really will tell you the best way to let the baby out. My last babe was 10# and had his chubby little arm across his chest with his hand by his opposite ear. I'm absolutely certain that I would have had a C if I'd not been at home. We live near a university hospital where the docs are more interested in managing labor than natural birthing.
My midwives, though concerned at the length of labor and amount of pain, followed my lead. I took up a kneeling position also and the *little* fella just eased his way out. Praise God!
I also spent the last several weeks of my pregnancy begging St. Anne and Our Blessed Mother to be with me for labor and delivery. That helped so much.
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4Real Forums : Our Lady of Good Remedy and Care
Topic: Ways to avoid tears/episiotomies?
