Twisting while lifting heavy objects
is risky to your back

This article is not meant to scare you, but to educate you and your options with giving birth to your child.  There is always a time and a place where this may be your only option, but should be your last option.  It is important for everyone exercise their patient rights and just as important to be educated about the changes in your body. 

One of the largest controversies in childbirth today (besides the elective cesarean section) is whether or not an episiotomy is really necessary.  It is estimated that the episiotomy rate in the United States is 65-95% and the American College of Obstetricians and Gynecologists says that it is “not always necessary and should not be considered routine.”  But for some OB/GYN’s it is routine and it should be discussed with your physician what their episiotomy rate is and what alternatives to delivery you have. 

 An episiotomy is a surgical incision made into the perineum (the area of skin between the vagina and the anus).  The cut can be made toward the rectum, which is known as a median cut, or the cut can be made a little toward the side known as a mediolateral cut.  It is a matter of opinion on which may be better depending upon what area of the world you live. 

 Episiotomies are measured into four separate degrees.  A second-degree cut after an episiotomy, which is the most common, happens midway between the vagina and the anus.  Fourth degrees tear after an episiotomy, which is the least common, happens when the cut tears all the way to the rectum. 

It is said that episiotomies are to provide the following benefits:

• Prevents tearing
• Speeds up the birth
• Protects against future incontinence
• Protects the pelvic floor from relaxing
• Heals faster and easier than tears

However research has shown that:

• “Episiotomies do not prevent tears into or through the anal sphincter or vaginal tears.  In fact, deep tears almost never occur in the absence of an episiotomy.”

• “Episiotomies are not easier to repair nor do they heal better than tears.”
• “Episiotomies increase blood loss, as with any surgical incision made”
• “Episiotomies do not prevent birth injuries or fetal brain damage.”
• “Epidurals increase the need for episiotomy.  They also increase the probability of instrumental delivery.  Instrumental delivery increases both the odds of episiotomy and deep tears.” 
• “Episiotomies do not prevent relaxation of the pelvic floor musculature.”  Therefore, they do not prevent urinary incontinence or improve sexual satisfaction.”

“Episiotomies are not less painful than natural tears.  They may cause prolonged problems with pain, especially during intercourse.”

And the side effects:

• Infection
• Increased Pain
• Increase in 3^rd and 4^th degree vaginal lacerations
• Increased healing time
• Increased discomfort when intercourse is resumed

According to Dr. JM Thorp, in a book titled Episiotomy: Can Its Routine Be Defended? Stated, “There is little evidence to support the routine use of an episiotomy.  This procedure may well increase the incidence of third- and fourth-degree lacerations.  There are few data to support the premise that this procedure prevents pelvic relaxation.”

For further questions regarding prenatal health and exercise, you may contact Jasmine at jazziebaby@gmail.com