Lets Talk About Our Lady Parts, Shall We?

I promised you vaginas, so lets talk about them! We all have one and if you're like me, your lady parts are pretty important, so learning how to birth in a way that keeps them intact has become very important to me.

There are so more facts that I'd love to share, but in an effort not to blog you to death with all of this vagina talk (I really could talk about birth for days and days. If you're my friend in real life, you've probably had this internal conversation while nodding and smiling while I talked your face off, "When is she going to shut up....I mean, really. Can we talk about something unrelated to birthing children for once (or Vampire Diaries)!" I really just want woman to know what I DIDN'T know the first time around and

I want woman to have the experience of birth that we deserve to give ourselves.

So lets talk about our lady parts shall we!

What is my perineum and how does it work? The perineum is the region of the body inferior to the pelvic diaphragm and between the legs. It is a diamond-shaped area on the inferior surface of the trunk which includes the anus and, in females, the vagina. The perineum can become engorged and expands during birth. The elasticity of the vagina allows it to stretch to many times its normal diameter.

Episiotomy, the most common of operations in North America is a deliberate injury done to avoid what the perpetrator believes would be an even worse injury to woman during labor.

"Men take it for granted that their sexual organs can greatly increase in size and then become small again without being ruined. If obstetricians and woman could understand that woman's genitals have similar abilities, episiotomy and laceration rates in North America might go down overnight. But obstetricians of earlier generations planted the idea (which is still widely held) that nature cheated woman when it came to the tissues of the vagina and perineum (Give it one good stretch, and it's done for, like a cheap girdle), and A LOT OF WOMAN HAVE BOUGHT INTO THE IDEA THAT THEIR CROTCHES ARE MADE OF SHODDY GOODS." Ina May

As I am approaching the final weeks of pregnancy, and exploring what birth means to me, I've also been asking anyone who will share their expedience with me to tell me what birth meant to them.

A friend of mine gave birth to a five pound baby, unmedicated, in a hospital and before she even started pushing, the doctor said she "needed" to be cut in order to birth her (small) baby. She agreed but hasn't had feeling where her scar is ever since and regrets putting her trust in her doctor. She wonders if she had allowed her body to birth the baby without being cut, if it would have even torn, would the tear have healed better than her episiotomy, especially with having had such a small baby.

(Note, many woman have been cut and if this is your preference, all power to you. I wonder though can birth happen without a woman being cut? Lets explore shall we?!)

Another friend of mine has given birth to two babies (one 9 lbs, the other 10 lbs) at a birth center with a midwife and didn't need a single stitch. I was shocked to hear that she had such good sized babies & yet her vagina was completely equipted to allow both babies to come through with out a tear. Although both of their situations can not be compared as they are both completely different woman, with different birth attendants who have different beliefs about what the body is capable of doing, it upsets me that so many woman are being cut in order to have their babies.

The word "tear" strikes fear into the hearts of most woman, but when you take a close look at what a tear usually consists of, and what an episiotomy consists of, it is the episiotomy that should make woman more apprehensive. I know that a first degree tear is usually less than a quarter of an inch long (and doesn't normally require stitches at all. It will heal on it's own) whereas an episiotomy cut is sometimes much larger and severs tissue and muscle of the pelvic wall.

An episiotomy is a complete severing of all of the layers of tissue, muscle and nerves and is no guarantee of not tearing. in fact it can contribute to much more serious extension.

Episiotomy is done at least 90 percent of first time births in hospitals and again in most second or later hospital births. A maternity center association record of home births shows that out of almost 5,000 home births, there were only twenty two episiotomies and only one third degree tear. That's an episiotomy rate of about one out of every two hundred woman. Most European countries, the rate is only twelve to fifteen percent of hospital births. These facts (found in this book) make you wonder WHY so many woman "need" to be cut in order to deliver their babies.

Strong, consistent evidence tells us how unnecessary routine episiotomy is. Over the last century routine episiotomy have been performed with the theory that inflicting this trauma on the mother saves her form a serious tear, improves her husbands sex life, saves her from urinary and fecal incontinence, saves her baby from shoulder distocia, makes the Dr's job of sewing up afterward easier and prevents oxygen deprivation, mental retardation and brain injury in the baby. All of these claims were made and widely accepted without any supporting evidence by doctors and hospitals all over North America. The trouble is that none of them is true. Medical science knows that routine episiotomy has NO benefits and carries many serious disadvantages.

Disadvantages of an Episiotomy:

-cause pain that sometimes lasts for weeks or months

-increased blood loss

-cause more serious tears because a cut perineum is not as resistant to laceration as an intact one

-often becomes infected

-are associated with wound breakdown, abscesses, permanent damage to the pelvic floor muscles and other complications that cause in continence (for example, recto vaginal fistulas-openings between the vagina and the rectum_

-prevent many woman from breastfeeding because of the pain they cause.

Reasons to receive an Episiotomy:

-When a baby about to be born is in distress or when a breech male baby's testicles are the leading part to be born.

I interviewed a doctor who said that he WILL NOT and does not support episiotomy because often times, a woman gets cut and then they end up tearing anyway, so they have to repair a cut and also a tear. And he stated that sewing up a tear heals more naturally than sewing up a cut. I asked how he helped prevent tearing and he said that by supporting the perineum and guiding the mother to push on her own accord, when she has the urge to push, when she is not on her back and when the baby comes out slowly and gently, tearing is less likely to happen. The problem is that most doctors don't deliver babies this way. They prefer women on their backs.

If you want to avoid an unnecessary episiotomy, find a doctor with an episiotomy rate of 15% or less.

While reading Ina May's book, I realized that I also was under the assumption that maybe you have to be cut to deliver your baby. Maybe my vagina really is just too small and won't open up large enough to fit a baby.... Is it even possible to give birth and keep my perineum intact?

Upon speaking to my midwife about the episiodomy controversy, her thoughts on it were rather surprising. She confessed that when a woman is given the right tools (doing squats to lengthen her muscles, perineum support during birth & keegels) tearing is less likely to happen. She delivers 70+ babies a year and has maybe 4 mothers with tears that needed repairing, while 90% of first time mothers in hospitals are receiving routine episiotomys. Once you sign your rights away, you give the doctor permission to do whatever he needs to do to deliver your baby, whether that means cutting you or not and you may not even realize it's being done.

Babies are squishy! They're meant to squish out!

In building my confidence about the birth ahead of me, it is important to realize what my body is capable of and to discredit the fear associated with giving birth.

This video has a ton of great information.


In preparation for my birth, I have probably watched a gazillion births (not the kind you see on TV, but the real ones where you see full-on baby crowning-vagina in your face, where the mother is not on her back which seems to be best for the Doctor and not always best for the mother....) Seeing these videos, watching my friends birth videos and talking to everyone I can about birth has trained my heart and mind to realize that birth is a natural process and not to fear it.

I strongly believe that woman need to see birth happen with their own eyes so that they can become comfortable with it and know that they are capable of doing it without injury to their bodies & without unnecessary, unwanted cesareans. I also believe that woman can have beautiful, peaceful experiences where THEY are the ones in control (not hospital staff), THEY are the ones making educated choices for themselves and won't go into their deliveries, like I did with my first, completely unaware of how my body worked & how the hospital system worked. I do not believe that home birth, or birth center birth is for everyone, but knowing what your rights are in a hospital is so vital to having the experience of birth that we as woman deserve to give ourselves.

For the less squeamish, for the brave, a vaginal birth