The Episiotomy

On the subject of episiotomy (med. Slightly queasy “Episiotomy”) there will be many expectant mothers. Earlier the episiotomy was one of the most common interventions during birth. He was routinely made to prevent a possible crack.

Now you came off but that because turns out that a cut will bring any significant benefits. Today it is used only, if the baby is in danger.

What is an episiotomy?

An episiotomy is a surgical incision into the muscle tissue between the vagina and anus. He causes an expansion of the vaginal output and can therefore accelerate the birth. The episiotomy does not hurt usually. He performed during the head passage at the peak of a contraction. Then the tissue at the dam is highly tensioned and the mother can feel mostly nothing of them. After the birth of the cut with a small local anesthetic will be sewn. While it can tweak something.

Where do you cut the dam?

The episiotomy can be performed either direction after (median cut) in a direct line from the vagina. This section is quite short and heals well. But he has the disadvantage that he may further blow it up intestinal during childbirth in direction, which can later lead to complications. The cut is slightly laterally, or used (mediolateraler cut) about a 45 degree angle. Here the cut may be even longer, if for example the baby needs extra space. Check this article for maternity pants.

When is an episiotomy necessary?

The episiotomy has always then, when it has to go quickly, or if the baby’s stuck his legitimacy. In an emergency situation of the child, if E.g. the heart sounds are bad, the cut can help to speed up the birth. Also all “vaginal operational” deliveries, such as forceps or Nursling births, he performs. When the baby in breech “position”, so not with the head but with the rump ahead on the world, it is necessary. And whenever the insulating tissue threatens to seize uncontrollably.

Episiotomy or dam crack – what cures better?

If an episiotomy is needed, will be put to the test during the birth. Has shown in recent years but that the cut over the crack brings no advantages. Now we even know that a rift is healed mostly better. This is because that happens the dam cracks at the point of least resistance. So to speak of the natural “breaking point”. Often this crack is much smaller, than you would have used the cut.

Many factors are important for healing: how well was sewn, which material is used and how big is the wound. After three days, they should be no longer affected by the cut or crack. After about three weeks, the seam is completely healed.

What to do if hurts the episiotomy or badly healed?

Normally, the episiotomy should have no problems after a few days. Otherwise, maybe following tips can help you:

  • Keep the seam pretty dry, then heals better.
  • A cool compress helps with pain. But be careful that they get no bladder infection.
  • Stay too long on the toilet and not to press for a bowel movement.
  • Let air at the seam. Take off the panties and lie down on the bed or couch for 30 minutes with an old towel as a base.
  • Good for a short sitz bath with Calendula (no more than 2 min., otherwise soften the seam!)
  • If you have pain, you sit on a large, soft cushions or in a slightly inflated rubber ring. As a result, the dam is somewhat relieved.

Can I prevent so I need no episiotomy?

The events at birth, you have only limited influence. Nevertheless you can prepare your dam in the weeks before that, so that he is soft and stretchy. You can avoid an episiotomy or-Riss within your means. Begin a targeted dam massage with E.g. Johannis -, olive, or wheat germ oil approximately 6 weeks before the birth.

Can I decide whether I get an episiotomy?

Talk to your midwife on this subject when shooting in the hospital so that your potential concerns and wishes can be taken into account. They can also ask the obstetrician that they only perform an episiotomy, if it is really necessary for the health of the baby.

Questions

Here you can search with key words for questions regarding episiotomy, provided other expectant mothers on our physicians and midwives: questions and answers.