Friday, June 17

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


  1. loved this!

    when i was pregnant with my first child, having an episiotomy was the only thing about childbirth that really terrified me. but i read up on it, and realized just how unnecessary it was. i've delivered two boys, one 7 and one 8 pounds, without a single tear or cut.

  2. In *most* cases, if you have a supportive team, you will not tear. If your team is using hot towels, olive or coconut oil, and massage during pushing, they can totally prevent tears. Women who've been cut will never actually know if they "needed" to be bc they were never given the chance to push. Plus, recovering from an epesiotomy is much more difficult than recovering from a tear. Since we had a midwife at both, my girls [7.5 &8 lbs] both came out-one after 20 mins of pushing, the other after less than 5 [which pretty much guaranteed me a tear since it was SO fast]- with less than a "skidmark". Plus, the scar tissue that builds up there after the procedure almost guarantees you'll be cut again the second, or third time around in a hospital bc it makes your perineum less stretchy, so there IS actually a reason for it. But if you use a midwife, they'll teach you some techniques to lessen the scaring and prepare you for an intervention free birth.
    Just my experience. Don't even sweat it girl, your vag will be nice and stretchy and that baby is gonna slide right out!

  3. I am lovin' this stuff! Keep on preaching :) I birthed an 8 1/2 lb baby girl without meds and without tearing(in a hospital with a midwife)!!! It sounds to me like you are taking all the right steps to prepare yourself. In case you need another birth story to ya go:

  4. Just say "NO" to episiotomies. Where did this concept come from that a woman's body can't deliver their baby??? Someone please tell me because it makes me furious. Women for thousands of years gave birth medicine, no forceps, no cutting and the world survived. Civilization carried on just fine.
    Your vagina will open to the size it needs to to get that baby out. It will. Whether you are religious or not don't you think our bodies are pretty amazing?...So, with that in mind, why would one of the most important parts (a woman's vagina) be inadequate in any way to deliver life????
    When a Dr. cuts you to let your baby out he is guessing how much room you will need. When your body makes room naturally, ie tearing, it only tears to the exact size your child needs to make its way into the world.
    My Mother had five children, naturally, she was cut with some one not with others, depending on the Doctor (some of the Doctor's did not even ask they just did it). She said she would rather tear any day before getting cut. She said you can barely tell while you are pushing that it even happened. But the healing is totally different.
    I have a friend who had an episiotomy after her first and her vagina was damaged after that. She could barely have intercourse with her husband because it hurt so much. Her second child she let herself tear and the issue corrected itself....pretty amazing.
    Our bodies are healers. Our bodies are wise. Our bodies know EXACTLY what to do to deliver our children. Say NO to intervention and YES to trusting what you were born with, what your were meant to do.

  5. Great info!!

    I love how informed you are and that you share it with us.

    I tore, but only a little bit. We did perineal stretches for the 5 weeks or so prior to delivery. (this might be too graphic for some :) My husband would use lubricant and run his finger back and forth to stretch it out. And then of course the nurses did it while I was pushing and viola, no issues! Of course it would have been nice not to tear at all, but honestly it wasn't that big of a deal and it healed pretty quickly. I have heard horror stories about women who don't just tear but ripped in like 17 different directions. Ouch!

    And good for you watching those births. I've only watched a few and I'm done. Can't do too many.

  6. I love all the information you are sharing! With my first child (I am currently pregnant with my second) I read up on all this stuff. There were a few things about my birth I knew for sure...I didn't want a c-section, I didn't want an episiotomy and I didn't want forceps used. I won't go into my long and complicated story, but I went thru a difficult and complicated labor and delivery (everything that could have gone wrong went wrong), which was midwife led. Doctors had to get involved. They wanted to use forceps as they knew I didn't want a c-section. I said no. They said they would try a vacuum first (which they didn't think would work). They wanted to do an episiotomy as it was an assisted delivery, I said no. My son ended up being born with the help of a vacuum and I tore, but I was very happy with the results. And today, I have no residual effects from that tear.

  7. Preach it Janelle! You rock! I love your heart for this stuff. You have taught me SO much!

    I love your passion and the info you've shared!

  8. I haven't had a baby, but I am always interested in learning more about this stuff so I am prepared for when I do. Thank YOU for sharing this!

  9. I have a serious physical reaction just READING about episiotomies! My mother has had three (with her three natural births) and talks about them like they are no big deal but the idea has always horrfied me!! Thank you for talking about this (no matter how much my chest tightens and I squint my eyes, trying not to form a mental image) because its something everyone should be informed about. There will be no cutting in my future if I can help it! No (unnecessary) C-section, no epi, no circumcision. Yikes.

  10. I had an episiotomy. My doctor was very much against them and knew how badly i wanted a natural birth . The nurses and student doc brought the surgical tray over 3 times before she finally cut me. My son was stuck. I pushed for 2 hours and made nice progress until he just stopped moving no matter how hard i pushed. little did we know he was slowly suffocating inside of me. If she had just cut me the 1st time and pulled him out he would have prob. been just fine but because she waited he went between 3-5 without oxygen, had no pulse when he was born, and scored a 0 on the agpar. im lucky he is alive. i am very lucky he has had no brain injury from going so long without oxygen. I can not tell you how guilty i feel for having pushed so hard for a natural birth because i believe it was my insistence that made her hesitate which nearly cost my son his life.
    Before he was born I preached on and on about natural births and the evils of hospitals and interventions. I read every book on natural birthing and watched every home birth on youtube. I was incredibly judgmental of OBs and medical intervention in birth.

    After having witnessed first hand how it can save a life, i take it all back.

    trust me, episiotomy isn't that bad. its not ideal and should be a last resort but really, its not that bad.

  11. This is more than an awesome blog, it's a contribution to the field of study on so many levels. Thanks for posting it.