Monday 27 May 2013

Pregnancy & Childbirth: Episiotomy

Gynaecologist Dr T. Mokaya explains the two cuts you might get while bringing your newborn into this world.

Episiotomy

WHAT IS AN EPISIOTOMY?
An episiotomy is a surgical cut in the area between the vagina and the anus. It is made just before delivery to widen your vaginal opening, allowing the baby to be delivered more easily.

IS IT BETTER TO TEAR NATURALLY OR HAVE AN EPISIOTOMY?
Women who tear naturally generally recover quicker with fewer complications. Women who have an episiotomy tend to lose more blood at the time of delivery, have more pain during recovery, and have to wait longer before they can have sex without discomfort.

WHY I MAY NEED AN EPISIOTOMY?
If your baby is very big and your doctor needs extra room to work.
If your baby’s heart rate is high and he isn’t handling the last minutes of labour well, your doctor may decide that an episiotomy will help speed up the delivery.

HOW CAN I AVOID AN UNNECESSARY EPISIOTOMY?
Five to six weeks before delivery try doing a perineal massage (massaging a pregnant woman’s perineum – the area between your vaginal opening and the rectum). This may help in making it less likely that you’ll tear or need an episiotomy.

HOW IS AN EPISIOTOMY DONE?
Local anaesthetic is used to numb the area around the vagina so you will not feel any pain when the cut is made. After you’ve given birth, you’ll get another shot of anaesthetic to ensure you’re completely numb before the cut is stitched up.

RECOVERING FROM AN EPISIOTOMY
If you’ve had an episiotomy (or a tear), you’ll have stitches and you’ll need time to heal. Your stitches won’t have to be removed though; they’ll dissolve on their own seven to 10 days after delivery.

WHEN CAN I HAVE SEX AGAIN?
Your perineum should be completely healed four to six weeks after delivery. If your doctor gives the okay and you’re up to it, you can try having sex. At first you might feel some tenderness and tightness. Try taking a warm bath and leaving plenty of time for foreplay. Using a good water-soluble lubricant will help make sex more comfortable.

NB: If you try these methods and find that sex is still too uncomfortable, wait a while longer. If the pain continues months after you’ve given birth, be sure to talk to your doctor about treatment.

Caesarean (C-section)

WHAT IS A C-SECTION?
A C-section is the delivery of a baby through a surgical cut that your doctor makes on your stomach and womb. In some cases, a C’section is planned in advance, while with others it's done because of an unexpected problem.

Read more about a C-section here.

Both these cuts are manageable and will heal as long as you take care of the wounds. Contact your doctor if you think there might be a problem while you are still healing.

Cuts of life:Episiotomy
By Amanda Ndlangisa
Bona Magazine

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