Perineal

Unfortunately, an episiotomy during childbirth is often unavoidable. But that is not a big deal in itself. Here you will find everything about the topic and a few tips to help it heal faster.

Fears Of An Episiotomy

When the birth is imminent, many expectant mothers become a little panicky. One fear is the danger of suffering an episiotomy during birth. Perhaps you have already heard horror stories from others that they sat on a swimming ring for several days because of the pain of the perineal suture. However, it is usually not as bad as this story sounds. So do not panic! To take away your fear of the episiotomy a little bit I have collected some important facts for you.

Perineal Massage As Prevention

The perineal massage – midwives swear by it! The perineum should be as well prepared as possible for the birth. Therefore, you should start with the perineal massage weeks before the birth. Here you can find out how to do it!
The likelihood that the tissues will remain intact during birth can be increased by massage. Massage of the perineum makes the tissue softer and more flexible. However, it is not necessary to massage the tissue from the beginning. About six weeks before the expected date of birth is sufficient.

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What You Need For The Perineal Massage

A natural oil (olive or wheat germ oil) is sufficient. Special perineal massage oils (e.g. from Weleda) are particularly suitable.

How Does The Perineal Massage Work?

Place your leg on a chair or the edge of the bathtub and insert first one, then two or three fingers into the vagina and massage in a U-shape with light pressure in the direction of the intestine. One massage per day is enough. In addition, you can train the perineum with simple exercises. Stand with your back to the sofa or bed, squat with your legs wide apart and lean your back against it. Your feet are flat on the floor. The longer you hold the position, the better. You can do this exercise several times a day. However, there is no guarantee that your perineum will be able to withstand the pressure of childbirth even though you have been doing these two things regularly.

Tips For Pain Relief

So if it does happen that you do get an episiotomy or perineal tear here are a few tips for relief:

Lying down relieves pressure on the perineum and also on the fresh perineal suture
– Especially in the first 24 hours it is useful to cool the perineal suture. Put a washcloth filled with ice cubes on the perineal suture.
Fresh air is good for the suture. So lie down in bed without panties as often as possible and put your legs up, so the perineum gets enough air.
Homeopathic remedies (e.g. arnica) should promote wound healing.
Sitz baths with chamomile or oak bark extract from the pharmacy will quickly provide relief. Tip: Blow dry it, so the healing substance remains on the perineal seam

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It is best to ask your midwife which tips are suitable for you!

Perineal Tear Or Episiotomy? What Is The Difference?

An episiotomy will help your baby come into the world more easily because the opening will be larger. The little head will eventually have to fit through. An incision at the right moment won’t hurt. Still, there are divided opinions about helping with scissors. Without a cut, the fabric may tear, but only as much as it needs to tear for the head to fit through. If it is then sutured well, the perineal tear often heals better than the perineal incision.

Is An Episiotomy Performed For Every Birth?

No! Although the tissue around the perineum is put under a lot of stress during childbirth, during pregnancy the body prepares itself for childbirth. Hormones make the tissue soft and elastic. Although many women only have superficial tears, the perineal incision rate in Germany is 60%.

When Is An Episiotomy Necessary At All?

In the past, many doctors simply cut away, thinking that preventing tears would make healing easier. Today, we know better: a natural perineal tear heals faster than an episiotomy. However, there are situations in which an episiotomy cannot be avoided:

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-The CTG worsens, the baby’s heart tones drop, and the birth must be accelerated.

-When the baby’s head should get less pressure, because it is not yet fully mature.

-When the birth is completed with the bell or forceps, the doctor must cut, because the instruments need space.

How Damaging Is An Episiotomy To The Body?

No one can predict how the birth will go. However, there is no drama if an episiotomy occurs. It is a “predetermined breaking point” provided by nature, which divides in an emergency so that the child can be born healthy. And this is, after all, the most important thing or?!

How Is Going To The Toilet More Bearable After The Perineal Tear?

Many women ask themselves this question. Going to the toilet after episiotomy will be very unpleasant. It helps here a balanced diet, which softens the bowel movements. In addition, soft dried fruit, one yogurt a day and two liters of water a day can make bowel movements more bearable. A clockwise abdominal massage can help and have an antispasmodic effect.
By the way: Even with great pressure, the perineal suture cannot just burst open!

How Long Does It Take For An Episiotomy To Heal?

There are two factors that determine how long an episiotomy or perineal tear takes to heal.

– How Big Is The Wound?

Perineal injuries are usually first or second degree. Usually, there is little discomfort after about two weeks. It is more difficult with perineal injuries of the third and fourth degree. In this case, the anal sphincter is injured and it takes some time for the muscle function to return to normal.

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– How Well Was It Stitched?

An episiotomy or perineal tear is always sutured under anesthesia and treated with self-dissolving sutures. In the follow-up examinations by the gynecologist or also in the reviews by the midwife, optimal healing is checked.

What Complications Can Occur With An Episiotomy?

From time to time there are complications with an episiotomy. If the stitches are too tight or too tight at the vaginal entrance, it will hurt you later during sex or there will be a permanent pulling sensation. Many sutures with many knots also cause a lot of trouble, because they cause many scars.

Will The Midwife Take Care Of Your Episiotomy During Aftercare?

In fact, it is very important that the scar is looked at regularly by the aftercare midwife. There she will check if the bruises are receding, if there is inflammation or even if a correction is necessary. Always remember: a perineal tear or incision is completely normal during childbirth. You do not have to be uncomfortable in front of the doctors (for them it is normal anyway), nor should you worry too much about it. Many women have already experienced this before you and survived without any problems. A birth is always a challenge for the body, from which it usually recovers completely. And the most important thing is that your child can come into the world healthy and without problems.

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