The Episiotomy\nCut: Debate 2012: In 1935 Aldridge and Watson published their theory that\nperforming an episiotomy, which is a cut in the perineum to widen the vaginal\nopening for birth, would protect the mother\u2019s pelvic floor, and enable the\nmuscles to stretch less. <\/p>\n\n\n\n
In the early\n1900s gynecologists and midwives felt that episiotomies would confer protection\nof various pelvic floor problems, including prevention of prolapsed uterus.<\/p>\n\n\n\n
By the 21st<\/sup>\ncentury obstetricians were looking at all the factors leading to bladder\nincontinence and weakness of the pelvic floor muscles, and it was hotly debated\nas to whether these episiotomy cuts would be helpful or harmful. <\/p>\n\n\n\n Current policies generally recommend avoiding an episotomy.<\/p>\n\n\n\n In one study in Swewden Women who underwent episiotomy experienced a more complicated and emotionally difficult delivery. They reported a higher frequency of dyspareunia and insufficient lubrication than women who had given birth without episiotomy. Arousal, orgasm and satisfaction with sex were not affected. Episiotomy, perineal lacerations, fundal pressure at delivery and a history of dyspareunia were independent risk factors for dyspareunia 12-18 months postpartum. <\/p>\n\n\n\n The subject\nis complicated by the fact that women have some bladder dysfunction, and\nprolapse, immediately after delivery that resolves relatively quickly. The\ndysfunction immediately after delivery probably comes from temporary weakness\nor paralysis of nerves of this area, secondary to the baby\u2019s head pounding\nagainst the pelvic floor and it\u2019s muscles. <\/p>\n\n\n\n In a study\npublished in Obstetrics & Gynecology in 2012 a group of\nresearchers from the Johns Hopkins School of Medicine looked at women 5\nand 10 years after their deliveries to determine how they fared. Specifically,\nthis study was interested in \u201cwhether a woman tore\u201d her vaginal area in the\nprocess of birthing. And they asked in the subsequent years of a woman had\nincontinence, overactive bladder, anal weakness and prolapse (dropping) of the\nbladder. They looked at whether a delivery had forceps or a cut or just had a\ntear in the process of delivery. And they couldn\u2019t find any association between\nthe pelvic complaints or whether the patient had an episiotomy. <\/p>\n\n\n\n Actually,\nhaving delivered by forceps, or if you have had a tear, the pelvic floor is\nworse. Women with multiple tears were actually worse off, so if you had a tear\nin one delivery, you need to think about ways to avoid this in other\ndeliveries. Other causes of potential injury are many. Just having a birth\nthrough the vagina can lead to more pelvic floor dysfunction. Larger babies and\nlonger times in the second stage can cause problems. <\/p>\n\n\n\n So, \u2018bottom\nline\u2019 is how do we protect the pelvic floor. Birthing isn\u2019t the only\nissue, you can\u2019t strain too much when having a bowel movement, nor lift heavy\nobjects regularly. Oddly either choosing\nto have no children, fewer children, or no vaginal births (elective c-section)\ndo all work to prevent some of these injuries, but aren\u2019t reasonable solutions\nfor moms to be. Good nutrition so that your muscles are well developed and not\nweak, avoid toxins (caffeine, cigarette smoke), normalize weight gain (so babe\nis normal sized too!), and protect nerve function by not being diabetic. <\/p>\n\n\n\n There are\nnew technologies, such as the Emsella chair, to improve the way Kegel\u2019s\nexercises are done, and FDA cleared for the treatment of urinary issues.\nWhether Emsella can both improve the pelvic floor once you have had a child,\nand can be preventative technology is not yet known. <\/p>\n\n\n\n Once it\ncomes to birthing, let your obstetrician or midwife decide how to effectively\nshorten the second stage of labor , and if you need an episiotomy for the baby,\nit\u2019s not going to harm the pelvic floor. <\/p>\n","protected":false},"excerpt":{"rendered":" The Episiotomy Cut: Debate 2012: In 1935 Aldridge and Watson published their theory that performing an episiotomy, which is a<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"colormag_page_container_layout":"default_layout","colormag_page_sidebar_layout":"default_layout","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[14],"tags":[],"class_list":["post-1991","post","type-post","status-publish","format-standard","hentry","category-our-gyno-health"],"_links":{"self":[{"href":"https:\/\/blog.womenshealthpractice.com\/index.php?rest_route=\/wp\/v2\/posts\/1991","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blog.womenshealthpractice.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.womenshealthpractice.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.womenshealthpractice.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.womenshealthpractice.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1991"}],"version-history":[{"count":1,"href":"https:\/\/blog.womenshealthpractice.com\/index.php?rest_route=\/wp\/v2\/posts\/1991\/revisions"}],"predecessor-version":[{"id":1992,"href":"https:\/\/blog.womenshealthpractice.com\/index.php?rest_route=\/wp\/v2\/posts\/1991\/revisions\/1992"}],"wp:attachment":[{"href":"https:\/\/blog.womenshealthpractice.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1991"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.womenshealthpractice.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1991"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.womenshealthpractice.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1991"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}