Few things make a pregnant woman cringe more than the word episiotomy. I'm not even pregnant and I just crossed my legs. And the weird things that happen to your vagina when you have an episiotomy, a surgical cut from the vagina to the anus, might make you shiver.
Sometimes an episiotomy is unavoidable, noted the New York Times. Like when a woman's perineum (the part of your anatomy between your vagina and anus) is exceptionally tight and won't stretch enough to allow the baby's head to crown, or a baby needs to be delivered immediately and there's just not enough time for the mother to push. Another reason, according to the same New York Times article, in which an episiotomy might be indicated is when a baby has a really large head and your physician wants to prevent a rectal or urethral tear (ouch).
A study published in Obstetrics & Gynecology by the American Congress of Obstetricians and Gynecologists (ACOG) recommends against the standard use of episiotomies. This is kind of a big deal in the medical community. The Practice Bulletin published by the ACOG suggested that physicians should take precautions against making episiotomies routine. Instead, the study suggested another suturing technique, and use of antibiotics at the slightest obstetric anal sphincter injuries. Preventative measures like long-term monitoring and pelvic floor exercises (practice kegels throughout pregnancy) as well as massage and warm compresses applied to the perineum during second stage labor (what Mayo Clinic referred to as the final stage of active labor) were encouraged by the ACOG.
Additionally, the aforementioned New York Times article brought up the issue of consent when you're giving birth. You have the right to refuse an episiotomy. However, if an episiotomy is unavoidable, you will get through it because it will help bring your baby into the world. Some weird things will happen to your vagina, but you've got this.
1. The Muscles In Your Vagina Will Have To Heal
Louana George, a registered nurse and certified professional midwife who delivered babies for 25 years told the New York Times that episiotomies cut through muscles, while the majority of natural vaginal tearing just occurs in vaginal tissue. Because the episiotomy incision was made into muscle, a longer healing period is required.
2. The Area Leading To Your Anus Will Tear
One of the most painful aspects of an episiotomy is the tearing of the perineum, which can lead to obstetric anal sphincter injuries reported the ACOG in their July study.
3. The Urge To Urinate Might Become Painful
Both the New York Times and the ACOG study reported painful urination as a side effect of vaginal tearing. This may last up to several months postpartum.
4. The Urge To Urinate Might Become Frequent
Additionally, the New York Times and the ACOG study claimed that along with painful urination, vaginal tearing resulting from an episiotomy might result in more frequent urination and incontinence (the inability to control the bladder, according to Mayo Clinic).
5. The Vaginal Tearing Might Give You Psychological Trauma
The ACOG's study also reported that psychological trauma might result from vaginal tearing. Sometimes, this trauma will cause women to request cesarian births for future pregnancies.
6. The Medio-Lateral Incision Can Prevent Anal Tearing
There are two types of episiotomies: a median incision and medio-lateral incision, according to the United States National Library of Medicine (NLM). Median incisions, a straight cut, are more common. Medio-lateral incisions are made at an angle, and can prevent anal tearing and sphincter injuries. However, these types of incisions take longer to heal.
7. The Cut And Stitches On Your Vagina Might Get Infected
Another reason the ACOG recommended against routine episiotomies, is the potential for infection. However, the good news is that physicians are taking note of the best practice suggestions. In 2012, 12 percent of vaginal births involved episiotomy, down from 33 percent in 2000.
8. The Tissue Inside Your Vagina Might Bleed A Lot
The risk of blood loss increases significantly with an episiotomy noted the NLM. This is expected, so load up on sanitary pads to make the best of a bad situation.
9. Vaginal Intercourse Will Be Painful Postpartum
It's not uncommon for women to make multiple trips to her OB-GYN because stitching needs repair for several months postpartum, reported the ACOG. That pretty much rules out vaginal intercourse. On the bright side, there's always the clit.