Tuesday, February 25, 2014

Episiotomy and Perineal Tearings


While preparing for my sun’s delivery 2 year ago, one of the most important points I was focusing on was how to avoid episiotomy. (Episiotomy is a surgical cut made in the lower opening of the vagina to enlarge it prior to birth) I can’t tell you exactly why it was so important to me…  One never thinks she would be that uniquely tragic case when the cut happens to be far too long which irreparably goes all the way to the anus and this way puts an end on lot of good things in life… I certainly heard from a midwife that there is a good research to show that episiotomy may precipitate more extensive tearing at the perineum.  Anyways, I thought if it’s possible to deliver without any cuts, I’d like to do it that way.

First of all I talked to other moms in my neighborhood. As a result I chose an obstetrician, who was the obstetrician of one of those moms who managed to deliver without episiotomy.  (Van Dijck Roland / Heilig Hart / Leuven, Belgium).
Secondly when we met for the first time, I asked him, how he relates to episiotomy; whether he’s ready to work with me on avoiding it. Some obstetricians –I would say from the old school- administer episiotomy automatically… According to my experience at first delivery in Colombo, Sri Lanka, delivering without it requires a team work. Meaning that the obstetrician takes the new mom and all her reaction into consideration.  At one point my doctor in Colombo asked me to push slowly, gently, so no sudden tearings would occur-he said. With my second pregnancy I was in Belgium, and I asked  Dr Van Dijck’s opinion. His response was satisfying. Even cooperative obstetricians would not say, “oh no, I would never do that horrible thing!”, just keeping the door slightly open they would say  “If it’s possible I would not administer episiotomy”.  So I went ahead with him. 

Later on during my pregnancy I met the wonderful Dr. Francesca Spada, mother of 3. She explained me how to do the perineum massage, which helps to prevent episiotomy.  Here you can see: perineum massage on you tube

I also knew that prevention starts with good nutrition, because tissue that is exposed to a good diet will have more elasticity. My diet is super good, and it made me quite self-confident despite of my age (above 40), and despite of the way doctors looked at me during my pregnancy due to my age... 

I brought warm compresses to the delivery room, that we did apply for a bit right before the pushing phase, but eventually didn’t have the energy to deal with it seriously.  

One of my nurses recommended the side position as well. It’s said to be one of the best ones in avoiding any unwanted tearings. Because of some reason eventually I delivered in the classical position laying on the back… this carries the highest risk.

Next day after delivery the kinesiologue asked if I can sit on a chair, “of course”- I said proudly.  “So you did the perineum massage?” - She smiled. –“I’ve never met anyone who needed episiotomy after applying perineum massage.” Working at the delivery department in a city hospital she’s met thousands of new moms, she knows what she sais I reckon!

GIRLS in my AVIVA CLASSES found FURTHER GYNEACOLOGS and Midwifes, whom they had good experience with:

Dr Francesca Spada / St Luc and Medicis / is very opened with regards to alternative approaches. She's knowledgeable in pregnancy diabetes diet and perineum massage as well, with which you can avoid episiotomy during delivery. She herself is a mother of three, her last kid was 5kg whom she delivered without episiotomy. Expect a long waiting list, she's busy!

Dr Frederic Buxant is very considerate when it comes to the client as a person. http://www.cmce.be/.

Dr. Soto, finds it a failure if he has to administer episiotomy. He's got a busy schedule, quickest to get appointment to him at Louise Medical Center
Cavell: 02 340 4340 (http://chirec.be/en/)
Centre O+ Medical, Saint-Gilles: 02 537 9092 (http://oplusmedical.be/)
Louise Medical Center, Ixelles: 02 534 2999 (http://www.louise-medicalcenter.be/)

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1 comment:

  1. May I ask you who was your doctor in Colombo? I live in Colombo and am considering delivering here. Thank you in advance.