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Routine Use of Episiotomy Not Beneficial – As the Bradley Method classes and midwives have been saying for decades
You may have read in May 2005 on the front page of the Washington Post an article about the fact that routine episiotomies are not beneficial to mothers, either in the immediate or long-term (as reported in the May 2, 2005, issue of JAMA). Episiotomy is the most common surgical intervention in childbirth in the US – fully one-third of vaginal deliveries include them. (In many local DC obstetrical practices, the occurrence rate is much higher). Women who experienced spontaneous tears without episiotomy had less pain than women with episiotomies. Complications related to the healing of the perineum were the same with or without episiotomy.
In addition, the evidence showed that episiotomy did not protect women against urinary or fecal incontinence, pelvic organ prolapse or difficulties with sexual function in the first 3 months to 5 years following delivery. No research described the long-term impact of episiotomy later in adult life when incontinence is most likely to occur. LADIES, this is UNNECESSARY TRAUMA to your sex organ. Don’t take my word for it. Read the full report at: www.ahrq.gov/downloads/pub/evidence/pdf/episiotomy/episob.pdf.
Here in Northern Virginia/DC, people seem to think relaxation is a luxury they simply cannot afford. In pregnancy, however, and especially as you approach your time of birthing, the reality is you cannot afford not to relax. But “how?” - you say. Here are some tips (borrowed liberally from Dr. Dean Ornish) everyone can use RIGHT NOW and every day:
Breathe: Even when you can’t control a situation, you can always control your breathing. You know what you need to do – deep belly breathing, call it yoga breathing, call it chakra breathing – it doesn’t matter what you call it, but you’ve got to slow down and really get that breath all the way down to your toes and then out the top of your head – versus – shallow, fast, top of your chest breaths. Just deep breathing alone will change your physiologic reaction to a stressful situation, helping you keep a clearer head and make better decisions. Deep breathing should be done whenever you think of it throughout your day – any time, any where – it’s free and your baby will thank you.
Meditate: Okay, okay, so you don’t even know what that is. No, you don’t have to configure yourself like a pretzel, or say “Om” (unless you want to). Meditation is simply the practice and process of paying attention to and focusing your awareness. Even a few minutes a day will be beneficial for you and your baby. One perinatologist calls it “taking a love break” with your baby. Take some time to just focus on your baby and send some love and peace to your little one. Think thoughts of gratitude that your body is nurturing and growing a beautiful, healthy baby. Be aware of all that positive life force flowing between you two. While you are meditating, with practice, your body will decrease your blood pressure, slow your heart rate, and dilate your arteries. Beyond those notable physical benefits, you will also find that your mind quiets down, and you can be more in touch with your inner sense of peace, joy, and well-being. Meditation is both effortless and hard work: a wandering mind is part of the process. With practice, your mind will wander less. Consistency is more important than duration.
Move: Yes, movement will help you relax. If you don’t like to exercise, don’t call it exercise. Just move. Take walks. Choose the stairs. Park further away in the parking lot. Go for a swim (you’ll be light and graceful – even with that nice-sized belly!) Find ways to keep yourself physically active all the way ‘til it’s time to birth your baby, and you’ll sleep better at night, you’ll release some tension, and you’ll have an easier labor.
ELECTIVE C-SECTIONS ON THE RISE
The number of women choosing c-sections between 1999 and 2001 rose 19%. That number rose again from 2001 to 2003 by 37% nationally, while in Virginia, the percentage increase from 2001 to 2003 was 44%. Are these women who are choosing cesarean delivery aware that the risk of their own death from a surgical delivery is at least four times higher than from a vaginal delivery? Are their husbands/partners aware of this increased risk??? How much fear must a woman have of her body’s natural functioning to choose to put herself in harm’s way? Is real, substantive informed consent happening in all of these cases? C-sections are not pain free nor are they done without substantial and significant risks. Before a woman would choose an elective cesarean (or not to pursue a VBAC), it would be so illuminating to her to attend a meeting of ICAN, the International Cesarean Awareness Network; there she could talk with and listen to women who have had cesareans and women who have had VBACs. Surely, those women who have actually personally had those experiences are in a better position to speak frankly and openly about them. (Statistics from the Washington Post, Sept. 15, 2005)
HANDS AND KNEES IS A GOOD POSITION FOR ACTIVE LABOR
The New York Times reported on research by the Cochrane review, which found that women who use a hands and knees position during labor may experience less pain, particularly back pain. This does not come as any news to midwives (or doulas, for that matter. Aimee has been suggesting hands and knees as a labor position in hospitals for years. Just because your birth team hasn't seen it before, doesn't mean it can't be done!)
The researchers used three previous studies, which involved a total of 2700 women, to arrive at their conclusions.
~ New York Times, 16 Oct 2007