41 answers

Level 4 Episiotomy........

I had a level 4 episiotomy during labor with my last pregnancy. Without exaggeration it was a horrible healing process that took over 9 months to completely heal. My baby is now 16 months old and my husband and I would like to consider having another baby after my son turns 2. Honestly the idea of having another episiotomy after the last experience leaves me feeling very concerned. I have to wonder if they cut me again down there if I will be able to heal again! I was just wondering if any other woman had an extreme episiotomy like this, and went on to have another vaginal birth? Also if it would be appropriate to request a c-section considering how awful the first healing experience was? Just wondering if anyone has been through this? It's the only thing holding me back from wanting to have another baby! Thank you

What can I do next?

So What Happened?™

Thank you everyone for taking the time to respond to this question! I have got so much great feedback, and a lot of useful information. This is something I am going to give much thought about before I decide to have my second child. I cannot express in words what a horrible painful experience the last healing process was for me. The whole experience was very traumatizing, but with that being said I will weigh what is best for me and my future baby. I really really appreciate all the responses. It is nice to talk to other women that have experienced the same thing and can relate. Thank you all for your encouragement and advice!!!

Featured Answers

I had the same results. With my second child I did NOT have an episiotomy and everything was just fine. No tearing etc. I think doctors do this and now I think it's silly. I would definately have another vaginal birth and simply refuse an episiotomy. there is an e-mail below re: peaceful birthing. My 2nd birth was 23 years ago but I did self hypnosis and had a wonderful birthing experience. I could have given birth again 5 minutes later. It was fantastic. I would definately look into this if I were you. Good Luck.

Oh my gosh, that sounds painful to say the least. I have an 11 month old and had him by c-section. I would never have had him any other way. I only took 1 pain pill in the hospital(not even because of pain, but because of pulling), was out of the hospital in 3 days, had my staples out in 5. However, I have a pretty high pain tolerance. Plus, the scar is almost gone. I would honestly look into a c-section more.

More Answers

You can always refuse an episiotomy. There are VERY few instances when an Epi is actually needed, And intentionally cutting a 4th degree Epi is...well unnecessary.

C-sections are rough to recover from too. I've had three very much unwanted c-sections the first was a preventable (failed induction for no reason) the second was unnecessary (coerced into agreeing by the ob) the third was necessary (after laboring, and pushing for 12hours it became necessary) I will not be planning a 4th c-section, rather I am planning to VBA3C when I become pregnant again.

Let me tell you why.

There are several potential complications to the baby during/following a c-section.
1. unintentional prematurity (thinking a woman is 38wks when she's only 36 is a problem)
2. 2-5% of babies are "nicked" during surgery.
3. Respritory distress (ranges from needing extra oxygen to needing intubation and a NICU stay)
4. Children born by c/s are more likely to have asthma and allergies than vaginally born children.
5. Children born by c/s are less likely to be breastfed (because the trauma of the birth on the infant and or mother causes pain/difficulty in nursing) (not saying anything "bad" about women who can't or chose not to breastfeed, other than scientific data shows that breast is best)

Lets not forget the risks to a Woman during/after a c/s which include.
1. High level of blood loss (2-4x's the amount lost during a vaginal birth)
2. Hysterectomy
3. Damage to surrounding organs.
4. Secondary infertility (unexplained misscarriages and stillbirths, inability to become pregnant)
5. Increased risk of Post Partum Depression.
6. Infection which could mean months of cleaning and packing an open abdominal wound.(btdt not fun)
7. Death.

Weeks-Months of recovery time depending on the skill of the surgeon. (all of my c-sections took 2months to 1yr to heal fully, by that I mean it took that long to no longer have pain in/around the scar area, that's not to say I was completely healed as I still have problems with adhesion (scar tissue) pain in my abdomen)

If you would like to talk to other women who are and have had to make the c-section/vaginal birth decision check out the forums on www.ican-online.org (http://www.ican-online.org/forum/index.php)

1 mom found this helpful

S., I just wanted to add that if you do opt for another vaginal birth, be sure to shop for a midwife or OBGYN who has a low episiotomy rate. You are the customer, and you have every right to ask before making a decision on a provider.

1 mom found this helpful

With my first daughter I had an episiotomy and then tore on top of that. So all told, I ended up with 4th degree tearing/episiotomy also. While the healing wasn't fun, it definitely did not take me as long to heal as it did you. Prior to the birth of my second child I expressed to my doctor that I would really prefer not to have an episiotomy unless necessary. So, with the vaginal birth of my second, I did not have an episiotomy. Instead, my doctor slowed down my pushing when the baby was crowning so her head could naturally stretch me. Also, he did some manual stretching and massage. I still tore some, but not nearly as much as I did with my first. I also was more relaxed during the birth of my second and did not have to push for as long. I think these things helped also. I went on to have a third vaginal birth. Again, no episiotomy, but still some tearing. I would discuss all of your concerns with your doctor. Be honest and s/he can hopefully offer you some helpful advice. A c-section is a pretty major surgery and will definitely take some healing time too.

You will notice a huge difference this time around. You have to remember that you were giving birth for the first time and you were not "stretched" out. Since you have had a child now, you shouldn't have much of a problem. Also, ask your doctor to stretch you during labor. My doc did this for me the 2nd time and I only needed a very slight episiotomy. Good luck! :)

You've already gotten some great advice so I'll be brief. I also had a 4th degree episiotomy with my first baby and I've gone on to have four more children with nothing even resembling that first experience. With my 2nd and 3rd I had tiny episiotomies (like 1 or 2 stitches) that healed quickly. With the 4th and 5th I didn't have any epi or tearing and the recovery was SO fast. My doctor is a big believer in perineal massage and during the labor we just took it slowly and she kept massaging to keep it from tearing. Definitely check around with different doctors and find one who will only do an epi if there is no other choice. And if this is the only reason holding you back from having another child, I say relax and go for it. Chances are, you'll never repeat your previous experience.

Hi S.,
I don't have any advice about the episiotomy-fortunately, I only had a little tear. Just wanted to say "good for you" for being a stay at home Mom- that is the best for your child. You are so lucky to have a terrific, supportive husband. Enjoy every day because before you know it, your son will be graduating from high school and you will wonder where the years went. I hope you are successful in having another baby.
Best Wishes,
M.

HI S.
I didn't have an episiotomy and only had a tiny bit of tearing. I was told to massage evening primrose oil on that sensitive skin down there the last week few weeks of pregnancy. The point is to gently stretch the skin yourself is it's more ready. A hot wash cloth compress while waiting for labor to fully kick in helps relax, and soften that area as well.
I also have an issue with laying on the back delivery's. I don't see why the doc's would want to fight gravity, and make delivery that much harder for both the baby and mom. I insisted on being as upright as I could. I'd planed on squatting but when the time came I was to shaky. But thats a very natural position that works with gravity. Any way if your interested in more info mothering.com is a great web site for natural birth and mom info.
Good luck, A. H

I have 3 kids! 8, 5, 7months.
I had 2 pretty rough episiotomys with the first two. and yes it took a real long time to heal. And with each, down there become a little more deformed and sensitive to healing.
I had a c section with my 3rd. because he got stuck after a full labor and pushing. But I want you to remember that a c section is not a walk in the park either!!!
You will ultimately be in a lot more pain in the beginning it is a very serious surgery and you will have a larger incision, maybe with staples (yuk)!! Healing time is not a fast process. it sounds like your body may heal on a slower level to begin with. Iv seen other women's scars and their almost unnoticable . my scar on my belly is still healing and its been 7 months its still raised, sore, red and itchy. and the area around still is very sensitive at times. But I find it alot easier to have a sore tummy than a sore whoha. also with the c section their is no unforeseen tearing. the cut is precise and planed!!!
hopefully you will be able to plan the c-section and not have to go through labor. just voice your concern to the doctors, make your opinion known and considered. I'M sure your choice of a c-section would be a valid option!

Required Fields

Our records show that we already have a Mamapedia or Mamasource account created for you under the email address you entered.

Please enter your Mamapedia or Mamasource password to continue signing in.

Required Fields

, you’re almost done...

Since this is the first time you are logging in to Mamapedia with Facebook Connect, please provide the following information so you can participate in the Mamapedia community.

As a member, you’ll receive optional email newsletters and community updates sent to you from Mamapedia, and your email address will never be shared with third parties.

By clicking "Continue to Mamapedia", I agree to the Mamapedia Terms & Conditions and Privacy Policy.