Let's Argue! (About Babies!)

[Thirteen]

I have a few touchy questions, and since my brain is only geared towards all things birth and baby at this point in my life, I thought I'd ask them here. Facts and opinions are both welcome on this subject, as I feel like most things regarding childbirth and rearing are a personal combination of each.

Epidurals: do they possibly encourage a more severe degree of tearing than what could naturally occur during delivery?
Selective Induction: aside from mandating maternal/fetal health problems, do you believe this is a good idea?
Episiotomy: an outdated practice, or something needed to prevent severe tears during deliver?
Perineal massage: crunchy and unnecessary, or a wise and helpful decision to prevent tearing?

I should answer these, since I'm posing them:
1). I let my epidural wear off, so I could push and be aware of the pressure/sensation during delivery. I believe this did, in fact, prevent me from tearing more than I did.
2). I am not sure why this still happens, and I'm in honest fear that if I'm ever 2 weeks past my due date in the future, they will induce me. My first and only labor experience was an induction, and even though it went much better than it could have, I still would not wish that on anyone. Ever.
3). Before pushing, I openly declared several times, "I refuse an episiotomy. I do not consent to one." to anyone who would listen. I think they make healing much harder, even than a bad tear, and I have a few friends who were not too keen to have a 'vagasshole' to deal with. (Their words, not mine).
4). We did it, it was weird, but I think it helped immensely.

[MarissaNicole]

Selective Induction: aside from mandating maternal/fetal health problems, do you believe this is a good idea?

I've had several friends/family members induced around their due date even though I don't think there was any serious harm to mother or baby, just that part of labor was progressing (I think they were close to either fully dialated or effaced) and that they were uncomfortable.

Perineal massage: crunchy and unnecessary, or a wise and helpful decision to prevent tearing?

When was it done? Did you use vitamin E leading up to delivery or did you just do a massage in delivery?

[diggitydot]

I had the massage done by my midwife with DD1 and after having 2 other kids, I totally see the value. No tearing, whatsoever. And yes, I'm pretty nutty/crunchy so take that into consideration, too. (She did it during the pushing contractions, IIRC.)

As for episiotomies, DH says they usually just make for larger tears. They prefer to not do them, even though sewing them up is usually easier than sewing up a natural tear.

Inductions for non-medical reasons bug me. Babies will be born when they're going to be born. I absolutely understand the "get it out of me now, dammit!" feelings, but that is just part of the gig. Now, for medical reasons, I'm absolutely on board. There are times when a lot more can be done for baby outside the womb than can be done inside.

I'm totally cool with epidurals. If I were to ever have another one, there's no question in my mind that I'd have an epidural. Of my three deliveries I did one completely natural (sans all meds), 2nd one I had a very late epidural because they thought I was going to need an emergency c-section, and with the youngest we walked in asking for drugs. Guess which one I have the fondest memories of? Yup, #3.

[SoonerTexan]

Epidurals: do they possibly encourage a more severe degree of tearing than what could naturally occur during delivery?

I'm torn. (pun intended) The choice to have one was completely mine and not one I completely regret. However, considering it was only on for 45 minutes, it might have been unnecessary. At the time, it seemed very very very necessary, though! In one sense it made pushing easier because it gave me a rest (I had been up for 27 hours at that point) and I'm not going to lie...I had a mirror and that shit looked painful. (I also commented to my husband that my nether regions did in fact look like my original photography logo--apparently it brought back my sense of humor. The midwife had to be WTF) I thought I had an hour or more left of labor when in reality it may have only been about 15 minutes. On the other hand, it made pushing REALLY ANNOYING. I asked them to turn it down and then to turn it off because I couldn't feel a damn thing and it definitely made pushing take longer. I actually wanted the pain at that point. As for tearing...I'm not sure. I had a 2nd degree tear. She was very bloated and over 9 lbs, so I'm sure that made a difference. I had no idea what I was really doing when I was pushing so yeah, I probably did some damage I might have avoided otherwise.

ETA: She was also born with her fist by her face. That couldn't have helped either.

I wish they would investigate using laughing gas in the US like they do in the UK...I think that would have been a better option for me in the last few minutes when it seemed like I just couldn't take it anymore. Also, I wish I could have had a little "less" of an epidural. I was lucid enough to ask if it was the type I could control with a button, but not lucid enough to remember what the reason was when the anesthesiologist said no. It only worked on one side at first and I wish I wouldn't have said anything, because that was enough for me to get through the pain all right and still know what was going on. The anesthesiologist asked what my pain level was before he left and I jokingly said, "Maybe a 1." and he said, "Oh, well we can take that to a 0 easily" and I declined

Finally (and I'm torn here too), I wonder if not having it might have helped with immediate bonding. Honestly, I was excited, but didn't feel much when they gave her to me and really didn't feel like she was mine for the first day or two. I'll admit I was wondering if something was wrong with me the first few days, but I hear that is relatively common. Then again, I was much happier after I got the epidural.

Next time, I'm hoping I'll have a shorter labor and will try to go without it for the reasons I mentioned above. And if I feel like I cant, I will have DH ask what options (if any) there are for an "epidural light" haha!

Selective Induction: aside from mandating maternal/fetal health problems, do you believe this is a good idea?

Before 42 weeks, I wouldn't do it. After, I understand the reasoning. I just had a friend deliver this way (she went to 42 weeks, wanted a birthing center birth, but had her water broken and didn't go into labor) and her delivery experience was just awful.

The hospital I delivered at does not allow non-medically necessary inductions or c-sections before 39 weeks, though of course you could get around it if you really wanted to. This is a recent change based on a March of Dimes study.

Episiotomy: an outdated practice, or something needed to prevent severe tears during deliver?

Didn't want one and don't ever want one unless the baby is in danger. I asked my midwife at the beginning of my pregnancy what her view on episiotomies were. She said she has done 3 (ever) and in each situation, it was a last resort and the mother was given other options beforehand (like, you can try two more pushes and then I'll have to do an episiotomy). The midwife supported my perineum the whole time and had DH squirting olive oil on the area during the entire pushing phase. N got her first oil hair treatment before birth

Perineal massage: crunchy and unnecessary, or a wise and helpful decision to prevent tearing?

On Wildfin's recommendation, we did it. DH was like, you want me to do WHAT? at first, but got used to it. It really did make a difference, but I think it would have been more helpful if we had kept it up more regularly closer to delivery. During labor would have been awesome, but we never did for whatever reason. Like any stretches, it just isn't as effective when you take a long break in between. I have no way of knowing if helped my 2nd degree tear from being a 3rd+ degree tear, but it certainly didn't hurt anything.

ETA: MarissaNicole, we did it every other day starting at about 36 weeks, but then slacked off closer to delivery. We used Olive Oil or Lube.

[spotty_dog]

Epidurals: do they possibly encourage a more severe degree of tearing than what could naturally occur during delivery?

Possibly. I seem to recall reading stats about coached pushing, which caused me to be adamantly against coaching. But if you can't feel, you have to be coached, you know? Also, I experienced a fetal ejection reflex with both babies. It's my understanding that this is triggered by the pressure of the baby's head on certain nerve bundles that tend to be numbed by the epidural anesthesia. So, since I got away without any stitches from two such births, I guess I feel like my experience is anecdotally in support of unmedicated birth -> less perineal damage.

Selective Induction: aside from mandating maternal/fetal health problems, do you believe this is a good idea?

Not really, no. I think that induction is a medical procedure with risks and benefits that must be considered. I think that the risk of further intervention needs to be part of the equation, and also the risk that a baby will be "evicted" before it's developmentally ready. There's a reason that iatrogenic prematurity is a focus of the March of Dimes -- it happens more than we like. If the only tickmark in the "pro" column for a purely elective induction is that a mama just doesn't want to be pregnant any more -- I just don't think that balances the potential cons. (I have a friend who had an elective induction at 37 or 38 weeks. Her son was born normal and healthy, but when he was a week or two old, a simple cold turned rapidly into a life-threatening lung infection and sepsis, complete with seizures from poor oxygen saturation, and weeks of hospitalization for neuro workup and treatment for the infection. Did he just have weak lungs and that's why something so simple turned so wrong? Who knows.)

Episiotomy: an outdated practice, or something needed to prevent severe tears during deliver?

Definitely outdated as a routine practice. Again, the risks and benefits must be considered. An episiotomy is an automatic second degree injury with a high potential to tear further at that weakened point. An uncut mother has a real chance to get away with a first degree or no tear at all. Practitioners who value the intact perineum have lower rates of tearing than do those who keep episiotomy at the front of their toolbox. I think that underscores that it's the skill of the practitioner (or his or her ability to keep their hands off and not mess with the process!) that determines the "necessity" of episiotomy.

Perineal massage: crunchy and unnecessary, or a wise and helpful decision to prevent tearing?

Prenatal or during labor? I did a bit of prenatal massage and felt that it helped me to better understand the stretching sensations of labor and work with my body. But it didn't give me an incredible elastic va-jay-jay or anything. I'm not sure if my midwife did any massage during the birth -- she certainly was going to town doing *something* with warmed mineral oil, but I was way too deep in labor land to know just what she was up to.

[TigerLily]

[QUOTE=Thirteen;568801]



Epidurals: do they possibly encourage a more severe degree of tearing than what could naturally occur during delivery? I'm not sure, but my epidural was much better with my second baby, and I didn't tear at all. Of course, that might have just been the 2 lb difference, and the first baby vs. second baby thing.
Selective Induction: aside from mandating maternal/fetal health problems, do you believe this is a good idea? Well...I always thought it was crazy and weird. And I guess I still do kind of, but I scheduled my induction for 39 weeks because I knew that it lined up with my husband's week off and I wanted him to be able to be there. Also, my first baby was 9lbs 14oz at 37.5 weeks so I guess we might have been a little bit concerned about size.
Episiotomy: an outdated practice, or something needed to prevent severe tears during deliver? I haven't ever heard anything good about them, but I've never had one either so I'm not sure.
Perineal massage: crunchy and unnecessary, or a wise and helpful decision to prevent tearing? I haven't tried that either, and I'm not sure if it's useful, but if it might be then I say give it a try!

[corn poffi]

Nothing helpful to add, but I do have to say that this board is the second best form of birth control ever! (The number one form is surgical residency).

[L.Jane]

Nothing helpful to add, but I do have to say that this board is the second best form of birth control ever! (The number one form is surgical residency).

Haha... seriously agree.... and add nannying to the mix. Best Birth Control EVER.. btwn these three things, kids are on the back burner until residency is over!

[SoonerTexan]

Sorry for the TMI. I've lost all shame since I gave birth.

[L.Jane]

Sorry for the TMI. I've lost all shame since I gave birth.

Haha.. no worries. I never had it, so I can't imagine how I will be after.

[GreyhoundsRUs]

Epidurals: do they possibly encourage a more severe degree of tearing than what could naturally occur during delivery?
Never thought about it, but I can see the logic behind it. I went without an epidural for other reasons, though...namely not wanting a needle in my spine and wanting to be able to move on my own.

Selective Induction: aside from mandating maternal/fetal health problems, do you believe this is a good idea?
My OB won't let anyone go past 41 weeks. I had pit b/c my water broke but I wasn't contracting (on my due date). I think there are other valid reasons to induce a little early - like knowing your baby-daddy has vacation at a certain time or will be out of town A friend was due NYE, but her hubby is our sports fellow, and so had to go to AZ for the bowl game - she was induced on Christmas Eve.


Episiotomy: an outdated practice, or something needed to prevent severe tears during deliver?
DH asked the OB not to do one when he saw her explaining to a resident how to cut. I ended up with only a 1st degree tear, but at the "top" (as opposed to the perineum). DH's philosophy is that you'll only tear as much as you need, but an episiotomy is equivalent to a 2nd degree tear.

Perineal massage: crunchy and unnecessary, or a wise and helpful decision to prevent tearing?
Why not Like ST said - what kind of tear would you get without? Who knows.


ST - the bonding thing happened with me, too. I told DH that I kind of felt like I was babysitting someone else's kiddo It doesn't help that you're not at home, and crazy (hormones and sleep-depravation)!

[GreyhoundsRUs]

Sorry for the TMI. I've lost all shame since I gave birth.

[TulipsAndSunscreen]

I am seriously having a visceral reaction to this thread - sweaty palms and an increased heart rate. I will revisit post-baby's arrival but considering that could be at any time, I think I need to not think about this stuff right now because I have a birth plan, I've met with a doula and I'm ready...and I don't want to freak out and change my mind now...

[diggitydot]

Don't freak out or change your mind. Just be prepared for you birth plan to go out the window at some point. It happens, don't sweat it.

[MissCrabette]

I obviously have nothing to add that's pertinent to the initial topic except... holy cow, very effective birth control!

Just be prepared for you birth plan to go out the window at some point. It happens, don't sweat it.

I meant to post this earlier, but I wasn't sure it would merit its own thread. Someone feel free to move this if you feel it's too much of a hijack. I actually heard an OB/GYN resident say that at this one particular hospital they consider a birth plan to be a risk factor. He says that everything that can go wrong usually does when the mom has a birth plan, and they're supposedly in the middle of a study on this very topic. I know that my knee-jerk reaction is that his statement comes across as very judgmental, but could there be a grain of truth to this?