An episiotomy is a procedure that is done to aid a hard delivery. It is an incision that is placed between the anus and the vagina to enlarge the opening for the birth of the child. The tissue that is involved is called the perineum. The incision is done in the stage of labour when birthing (pushing).Episiotomy was once a routine procedure that was done during childbirth. But, today, the use of an episiotomy is not very common and is done only when the child birth is too difficult to happen on its own.
The World Health Organization too advises that episiotomies should be done only in restricted cases. Despite these, in India, episiotomies are performed in a large majority of deliveries.Episiotomies do not paint a pretty picture. Though episiotomies are performed only when it benefits the health and life of the mother and the baby, it still is a surgical procedure.The procedure is safe; but it causes the loss of a lot of blood and also prolongs the recovery period after the pregnancy.
1.Talk To Your Doctor: There are a lot of doctors in India who still believe that an episiotomy is essential for a safe and healthy delivery. They are likely to perform an episiotomy on most of their patients. Talk to your doctor about their thoughts on episiotomy and ask them if they would try and avoid it as much as possible. If both of your ideas do not match, it will be best to look around for a more appropriate doctor.
2.Avoid Epidurals And Forceps: When you get an epidural for a natural birth, it makes you unable to push effectively. This may cause your doctor to need a forceps for the delivery and place an episiotomy. Forceps have been associated with tears and wounds. Epidurals can also cause difficult-to-repair tears due to improper pushing. To prevent these tears, the doctor may do an episiotomy, which is easier to stitch, manage and heal. Refrain from epidurals to avoid an episiotomy.
3.Choose Water Birth: In our country, bid birth or giving birth while lying on the back is most common. But research shows that this position can be the most difficult and painful one. It also has the most amounts of episiotomies placed. A water birth, on the other hand, is less painful and stressful to the body. Hence, it does not require the placement of an episiotomy. The water supports the body, cools it and assists the contractions during child birth. Though, water birth is not very common in India, you can ask around to find a hospital that offers it.
4.Patience While Pushing: The least amount of tearing and stress of delivery is seen when the mother is patient and takes her time. Listening to your body is the key to a painless and tearless delivery. Pause between the pushes and let your body get used to the expansion and contractions. Instead of pushing harder, try to push at a steady pace, which will help the tissue to slowly stretch, instead of being torn up due to sudden and excessive force. This will negate the need for an episiotomy.
5.Choose An Upright Position: The 'on your back' position puts a lot of pressure on your spine. It also restricts the expansion of tissue due to the uterus acting with the pull of gravity. Your baby will also struggle to pass through the narrow birth canal. If this is noticed, your doctor will have to perform an episiotomy to take the baby out. If at all possible, assume an upright position. The gravity will work for you and will assist the downward movement of the baby. This will reduce the risk of natural tears and will eliminate the need for an episiotomy.
6.Perform A Perineal Massage: The perineal tissue is very flexible and stretchy. Massage this part well before your pushing stage starts and continue it during the active labour period too. It is seen that the women who received the perineal massage did not require an episiotomy for the deliveries of their baby. To perform this massage, place the thumbs of your hands into the vagina to about 1 and 1½ inches deep. Press in the downward and side-ward directions. Repeat this till the tissue feels normal. You can start the massaging from the 34th week of pregnancy.
7.Eating Nutritious Food: When eating food, make sure that the food is good for the stretching of the vagina. Eat vitamins, proteins, fatty acids, etc., to keep the area flexible. Make sure that your meal has vitamin K in it too.
These are the ways to avoid episiotomy during childbirth.