Episiotomies, Tears, & Incisions, Oh My!

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By Debra Geymayr and Heather Lopez

Do these words strike fear in your heart? An episiotomy is an incision between your vagina and your anus and was traditionally done to prevent larger tears and postpartum incontinence. However, according to the Mayo Clinic, this procedure is pretty much unnecessary unless you have a high risk of extensive natural tearing, your baby is in an abnormal position, or the baby needs to be delivered quickly. Episiotomies have been shown to take longer to heal, to cause pain during sex for months afterward, in some cases result in larger incisions than the natural tears, and actually lead to more incontinence.

Fortunately, there are ways to prepare yourself for natural childbirth that can prevent or eliminate the chances of tearing, episiotomy and incontinence. One such method is doing Kegel exercises. (We will be doing an article in the fitness section on this topic next month.) These exercises strengthen your pelvic muscles and help to prevent incontinence. Another method is perineal massage.

Excerpt from The Birth Book By William and Martha Sears

The better you prepare your perineal tissues for the stretching of birth, the less they will tear, and the better they will heal. Like training muscles to perform at their best in an athletic event, conditioning the tissues around the vaginal opening with massage prepares the perineum to perform. Midwives report that women who practice perineal massage daily in the last six weeks of pregnancy experience less stinging sensation during crowning. Mothers with a more conditioned perineum are less likely to tear or get an episiotomy. An added value of perineal massage is that it familiarizes a woman with stretching sensations in this area so she will more easily relax these stretching muscles when stinging occurs just before the moment of birth.

Try this technique:

Scrub your hands and trim your thumb nails. Sit in a warm comfortable area, spreading your legs apart in a semi-sitting birthing position. To become familiar with your perineal area use a mirror for the first few massages (a floor-to-ceiling mirror works best). Use massage oil, such as pure vegetable oil, or a water-soluble lubricant, such as K-Y Jelly (not a petroleum-based oil) on your fingers and thumbs and around your perineum.
Insert your thumbs as deeply as you can inside your vagina and spread your legs. Press the perineal area down toward the rectum and toward the sides. Gently continue to stretch this opening until you feel a slight burn or tingling.
Hold this stretch until the tingling subsides and gently massage the lower part of the vaginal canal back and forth.
While massaging, hook your thumbs onto the sides of the vaginal canal and gently pull these tissues forward, as your baby’s head will do during delivery.
Finally, massage the tissues between the thumb and forefinger back and forth for about a minute.
Being too vigorous could cause bruising or swelling in these sensitive tissues. During the massage avoid pressure on the urethra as this could induce irritation or infection.
Check out this video on perineal massage:

Remember, it is important that you are prepared to handle the birth of your child and do not panic. Using relaxation techniques and breathing methods will allow you to manage the pain and assist you in birthing your baby with less chance of tearing. This will also assist you with recovering more quickly from the birth. Educating yourself about the childbirthing process is the most effective prevention strategy for risk of any tearing or incisions.

About Debra Geymayr, R.Y.T., HBCE, CD(DONA), CLD, CPD
She is the Directress of Prenatal Plus – Yoga based in Miami, Florida. Certified yoga teacher, registered with the National Yoga Alliance, childbirth educator, hypnobirthing practioner and holistic labor, birth and postpartum companion (doula.) Debra specializes in Pregnancy, Birth and Beyond. Classes in prenatal and postnatal with baby yoga, couples workshops, childbirth courses and more…Debra travels throughout the US hosting Prenatal Yoga Teacher Certification Training and is creator of the nationally recognized video “Yoga for Pregnancy”. Teaching for over 20 years, celebrating “Motherhood” with her daughter every day!! Debra has dedicated her life’s work to helping women and couples enjoy this amazing time together through education, connection and understanding.

Posted by hahmom   @   1 December 2009 1 comments

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