Pregnancy Lounge

Tag: child birth

  • More on Episiotomies (continued)

    Many recent studies have shown that routine episiotomies shouldn’t be performed, because they are not helpful to the majority of women, although there are certain circumstances when they are needed. Having an episiotomy can increase pain during the postpartum period, leading to a longer recovery time. In addition, women who have episiotomies may have weaker pelvic floor muscles as well as more pain when resuming intercourse postpartum.

    Episiotomy rates have declined over the years, but the number still remains high. Despite all the evidence against routine episiotomy use, close to 50- 80% of first time moms end up with an episiotomy in the U.S. The majority of women having them done are young white women, who have private insurance, according to a recent study.

    There are a few situations when an episiotomy may be medically necessary. If there is a sign that your baby is in distress while in the birth canal, such as slowing of your baby’s heart rate, an episiotomy may be unavoidable for the sake of your baby’s well-being. If your baby’s shoulders get stuck, if your baby has a very large head that cannot fit through the vaginal opening or if delivery happens too quickly for the skin of your perineum to stretch naturally, you may need an episiotomy.

    Perineal message helps reduce the chance of tearing during birth and the need for an episiotomy. It can make the perineum more flexible and increase elasticity, in preparation for birth. It’s a good idea to start doing perineal massage around the 34th week of pregnancy or before. To perform perineal massage, wash your hands thoroughly (or your partner). Place K-Y jelly, vitamin E oil or another mild lubricant on one or two fingers and gently stretch the lower part of the vagina until you feel a slight burning sensation. Hold the pressure steady for about 2 minutes or so. Repeat this daily for about 8-10 minutes.

    Warm compresses during labor (especially during the pushing stage) encourage the stretching and relaxing of the perineum. Make sure they are only warm, but not hot, which can cause some swelling. Positioning during labor and birth may contribute to whether you need an episiotomy or not. Squatting can help reduce tearing. Avoid laying directly on your back, if possible and keep changing positions if you can. Talk to your doctor or midwife early about your feelings regarding episiotomies, especially if you wish to avoid one.

  • Episiotomy

    A small incision during delivery is an episiotomy. Right before your baby’s head emerges during delivery, in the pushing stage of labor, you may be given an injection of local anesthetic and your doctor or midwife may make a small incision in the skin between your vagina and anus (your perineum). This is called an episiotomy. An episiotomy is usually a second degree cut in both the skin and muscle of your perineum made for the purpose of enlarging your vaginal opening to assist in delivering your baby. The incision is closed with stitches after your baby and the placenta have been delivered. It is one of the most common medical procedures performed on women and also one of the most controversial.

    There are two main types of cuts: a midline (the most common), which is a cut directly towards the anus and a mediolateral, which is a diagonal cut toward the side. The most common are second degree and the least common are fourth degree cuts.

    Many doctors believe that an incision heals more easily than a tear. Other claimed benefits of episiotomy include prevention of possible third or fourth degree lacerations, lacerations that reach the anus, incontinence later on, damage to the pelvic floor and injury to the baby, as well as shortening the pushing stage; leading to a quicker delivery. Some doctors say that episiotomies are preferred, because they are simply easier to repair.
    <<click here for the rest of the article on episiotomies.>>

  • Dealing with Postpartum Depression

    Having a baby is supposed to be a thrilling and exciting time, but for many women it can also be a time of fear, stress and even depression. After giving birth, many women (as many as 80% of new mothers) experience a week or two of “baby blues,” marked by mood swings, mild depression, and bouts of unexplained crying, but these feelings typically disappear quickly. Postpartum depression, on the other hand can be described as on-going or worsening intense feelings of sadness, restlessness, irritability or being consistently exhausted and unable to function. Up to 15- 30% of new mothers experience full-blown postpartum depression after delivery, which can last as briefly as 2 weeks, but as long as over a year.

    Common symptoms of postpartum depression include: constant or worsening feelings of worthlessness, helplessness or hopelessness, crying more than usual, lack of interest (or over interest) in baby or caring for baby, being unable to function, extreme exhaustion and sleeping too much (or too little), feelings of being overwhelmed or unable to cope, change in eating habits (not eating or overeating), change in weight, as well as loss of interest or pleasure in activities including sex. Also, being unable to make decisions, trouble focusing, feeling out of control or unusual feelings of rage and feelings of wanting life back the way it was before baby are common symptoms of postpartum depression. Frightening thoughts of suicide or harming baby and fear of being alone with baby that won’t go away are more serious symptoms, which a woman should seek help for immediately.

    << click for the rest of the article on postpartum depression >>

    Depression During Pregnancy
    Postpartum Depression
    Depression After Delivery