Episiotomy and Tears
An episiotomy is a small cut made at the entrance to your vagina to give your baby more room during the birth. In the 1970s, it was a fairly routine procedure, particularly with a first baby. Nowadays, the main reasons for an episiotomy are the need for a quick delivery because the baby is showing signs of distress or forceps are needed for the birth.
Although it may sound daunting, once you are in labour it becomes much less of an issue. If you need an episiotomy, the midwife will get your consent first and then inject some local anaesthetic in the area where the cut is to be made. The area is very thin at the height of a contraction, and it is then that the incision is made - with one guick snip of a pair of sterile scissors. You are more likely to need an episiotomy if you need an instrumental delivery.
Some women do tear during childbirth and there is no guarantee that this will not happen. However, there are steps you can take to reduce the risk. Massage the area with wheat germ or sweet almond oil to make it more supple, and practise your pelvic floor exercises so that you become more aware of that area and can relax it when it comes to pushing out your baby.
As your baby's head is delivered the midwife will ask you to 'pant', not push, in order to control the speed at which the head is delivered and to reduce the chance of tearing. Even if you do tear, it does not necessarily mean that you will be stitched. Small tears have shown to heal just as well if they are kept clean.
Position of tears
The most common tear goes from the entrance of the vagina towards your back passage. This area is called the perineum. A first-degree tear involves only the skin; a second degree tear involves skin and muscle; while a third-degree tear, which is less common, involves the lining or muscles of the back passage.
Sometimes tears are towards the labia or clitoris, and these can be extremely sore, particularly when passing urine. Drink plenty of fluids to dilute your urine and keep a jug by the toilet so that you can pour water over the urine as you empty your bladder, to make the discomfort more tolerable. Stitches do not have to be removed, as they will dissolve.