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Thread: Episiotomy ?

  1. #11
    Join Date
    Nov 2013
    Posts
    221
    Quote Originally Posted by galatea View Post
    Your doctor has given you clues that you might not like her during labor. I am sure she meant no routine episiotomies. You need one if she uses a vacuum, for example. However, assuming you will get an epidural and insisting on lying on your back are not good signs. If you have an epidural, you pretty much have to lie down, especially if the dose is high enough to make you totally numb. I have had one epidural, and I was very annoyed when I discovered that though it numbed the contractions, I still felt every inch of the baby descending through my vagina! I thought I was getting a numb vagina! I never had another epidural after that disappointment.

    However, if you are not medicated, lying on your back is pretty painful and very inefficient. In my unmedicated births, I vastly preferred hands and knees.

    There are usually options between standard OB and home birth. Have you tried to find a CNM practice?
    Thank you Galatea! I didn't realise that after having an epidural you have to lay down, I guess that explains why she said it to me. She seems to prefer that her patients do it this way, and that is going to be a problem for me. I mean maybe that is the route I will go down, but I'm not going to be making assumptions.

    A midwife has been ruled out - although this would be my ideal way of doing things - my Husband is completely and utterly terrified of something going wrong and wants a surgeon doing the delivery. I have never seen him afraid of anything before, and I don't want him to be afraid. I am happy to stick with an OB/GYN... just maybe not this particular one. I'm from England and a midwife delivery is standard unless there are any complications. People seem to have much nicer experiences doing it this way. Hopefully if all goes well with my first, my husband will feel more comfortable using a midwife the second time around.

    At my appointment on Thursday I am going to explain that I am considering switching to someone else because of my concerns. I will see how she responds. I think the biggest problem for me is that she doesn't explain her reasoning for anything.

    Thanks again everyone.

  2. #13
    Join Date
    Jul 2013
    Posts
    562
    Would your husband consider you seeing a midwife that practices with OBs? The practice I used with my children there were midwives and OBs in the same practice and overall they had some lower C-section rates compared to other practices in my area. I delivered in a hospital with a midwife but if something had gone wrong they would have had an OB there immediately to take over and I could have even met with an OB while having prenatal visits.
    The not sharing C-section rates (for whatever reason she should be honest with you), assuming an epidural and position seem red flags to me. I did have both my children laying down since my son descended too quickly to move (I asked while pushing if that was the best position and the midwife told me it was too late to move) and I had leg pain with every contraction with my daughter. Both babies were born very quickly without any issues from me being on my back.
    Mother to: Patrick Werner (3/10) and Mary Claire (06/12)

  3. #15
    Quote Originally Posted by themamae View Post
    Thank you Galatea! I didn't realise that after having an epidural you have to lay down, I guess that explains why she said it to me. She seems to prefer that her patients do it this way, and that is going to be a problem for me. I mean maybe that is the route I will go down, but I'm not going to be making assumptions.

    A midwife has been ruled out - although this would be my ideal way of doing things - my Husband is completely and utterly terrified of something going wrong and wants a surgeon doing the delivery. I have never seen him afraid of anything before, and I don't want him to be afraid. I am happy to stick with an OB/GYN... just maybe not this particular one. I'm from England and a midwife delivery is standard unless there are any complications. People seem to have much nicer experiences doing it this way. Hopefully if all goes well with my first, my husband will feel more comfortable using a midwife the second time around.

    At my appointment on Thursday I am going to explain that I am considering switching to someone else because of my concerns. I will see how she responds. I think the biggest problem for me is that she doesn't explain her reasoning for anything.

    Thanks again everyone.

    I have heard lots of moms say the same thing: "I will use a doctor with my first, and then a midwife with my second," but the problem with that reasoning is that the first one sets the tone for the rest, and it is in the first delivery that so many interventions can happen that might lead to a section and then it will be harder to have that second birth be more natural. The first birth is the most important, as in many communities, VBACs are not the standard of care. To give you an example, my first was induced because of very low fluid. It took 20 hours just to get to 3 cm, and then I got an epidural (not really sure why) and I fell asleep for two hours and woke up at 10 cm. Then it took 3 hours to push him out, but because I had a CNM, she was patient and let me do my work, despite the OB who was their attending specialist out in the hall pushing for a section. There were no disturbing signs with my baby; it was just taking a "long" time. It was only long by OB standards; I think it was pretty darn quick for being pretty numb and stuck on my back! In fact, my midwife covered the clock and kept encouraging me, and she was the only reason I did not have a section.

    My husband was also weird about midwives when we were pregnant the first time, so I bought this book (http://www.amazon.com/Thinking-Woman.../dp/0399525173), and he only needed to read the intro before he agreed to see a CNM. We had #1 and #2 in a hospital with a CNM and thus had all the safety of the hospital (quick surgery times, etc.) with the humane treatment of a midwife. I would highly recommend seeking out a CNM group and using them in a hospital.

  4. #17
    Join Date
    Apr 2013
    Location
    UK
    Posts
    505
    In my training, I've only performed one episiotomy in 45 deliveries. I don't like doing them personally but there are certain circumstances where they are appropriate. Anecdotally, I feel that tears tend to heal better but episiotomies are more controllable and less likely to go through something they shouldn't. Also, I wouldn't trust any practitioner who does midline episiotomies as they can cause more damage than a third degree tear in the long run.
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  5. #19
    Join Date
    Jan 2012
    Posts
    1,519
    To weigh in on the last part of your post, I had a second degree tear and it was fine. I was overall sore of course, from the birth itself, and sitting in one position was uncomfortable, but within a week I felt normal again.

    I'm sorry to hear about the troubles with your doctor. Mine doesn't have the greatest bedside manner, but he's excellent at what he does. It was also never assumed I would get an epidural, although I ended choosing one anyway.

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