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The perineal incision, routinely performed in Polish hospitals during childbirth, is in most cases not necessary at all. Find out about the methods of protecting the perineum and look for a midwife who knows and uses them. How to avoid an episiotomy?
Episiotomyis a real challenge for many women expecting childbirth. Is it possible toavoid the perineal incision ? If you are afraid of an incision and would prefer to avoid it - talk to your doctor or midwife about it and remind you that it is important to you. The more such "lobbying", the greater the chance that non-cutting will become the norm one day and in our country, just as family birth or rooming-in are the norm today.
Incision of the perineum: an appeal to doctors and midwives
We appeal to professionals: try to understand women's fears and do not underestimate their efforts. If the patient has been massaging the perineum for several months, exercising - appreciate it and try to help her. The woman in labor has the right not to want unnecessary surgical interference with her body, because only she bears the unpleasant consequences of this. And when the procedure is necessary - tell the patient about it, do not perform it without a word of explanation.
How to avoid an episiotomy: preparing your perineum for delivery
The perineum can be prepared by applying massages using oils (e.g. olive, avocado or sweet almonds), which makes it easier to massage and makes the tissues more elastic. Massage can be started from the middle of pregnancy, and for the last two months it is worth doing it every day (see the box next to it for how to do it). Kegel exercises are also invaluable. Thanks to them, the muscles of the pelvic floor and perineum will be more flexible, which will facilitate childbirth. In addition, Kegel exercises will teach you to control these parts of the muscles, and when you master the art of tightening and relaxing them, you will be able to refrain from pressure more effectively, which is very advisable in childbirth with perineal protection.
A good midwife will help you avoid an episiotomy
In modern obstetrics, staff do everything possible to protect the perineum. For midwives in Western countries it is an obvious part of their profession. In some centers, the perineum is not cut, even during labor with a vacuum tube, if it tightens itself nicely. A good midwife can do a lot. The most important thing is to be patient in the second stage of labor - let it happen without hastedevelopments.
There are also such midwives in Poland. Unfortunately, they are in the minority for now and are not always easy to reach. But as long as the incision is routine, it's probably the surest way to protect your perineum - hiring a good midwife who can and will take care of it. Women who have decided to go to a private hospital also have a better chance of avoiding an incision, because there are usually fewer deliveries there, and doctors more often take into account the expectations of the mother in labor.
How to avoid an episiotomy: the course of labor
The vertical position of the birthing body is very important. Then the head fits centrally, evenly compressing the tissues around the vaginal opening, while in the supine or semi-sitting position, the head presses against the perineal tissues (i.e. the place between the vaginal opening and the anus). In most such births, you do not need to do anything but observe the accidents.
First of all, you do not need to push - the force of contraction and the force of gravity make the head calmly and slowly move outwards, massaging and stretching the perineum. Pressing at this point can even be harmful, because it leads to excessive tissue hyperemia, which results in their breaking or the need to incise them. If the labor is too fast, the midwife should put her hand on the perineum and vulva to counterbalance the pressure head. Between contractions during the second stage of labor, the midwife can make warm compresses (e.g. with an infusion of lavender, chamomile or… coffee) to relax the perineum, and also recommend a special type of breathing.
Incision of the perineum will not always be avoided
Note: do not expect a 100% guarantee that the incision will not be made, because no one can promise you in advance. Perhaps, despite the goodwill of the staff, it will be necessary. So don't put it in such a way that you categorically disagree with it, just that you would like to try to give birth without an incision.
You must do itHow to massage the perineum?
Apply a small amount of oil (e.g. almond oil) to the vaginal opening and labia from the inside, and make gentle circular movements with your finger around the vagina. When the oil is absorbed, insert your fingertip into the vagina and press the bottom edge (towards the anus) inside and out until you feel a burning sensation. Don't press any more. After a few days of such a massage, attach the second finger. Gradually, if you can do it, massage it with three or four fingers - then the perineum can stretch up to 2/3 the size of a newborn's head.