Monday, December 31, 2018

How to Prevent Tearing or Episiotomy During Labor and Delivery?

What is Episiotomy?
An episiotomy is a small cut made into the perineum (the area between the vagina and the rectum) to widen the vaginal opening that performed by the health care provider to make delivery easier or to prevent tearing of the vaginal tissue. 
Episiotomy prevention exercise
Fig: Episiotomy prevention exercise
When an Episiotomy is Required?
Episiotomies may be necessary in case of the below situations:

  • It is required when your baby's heart rate drops and delivery is expedited by cutting the perineum.
  • If your baby's shoulder is stuck behind your pelvic bone (shoulder dystocia).
  • If you need an operative vaginal delivery (using forceps or vacuum suction).

14 Ways to Prevent Tearing or Episiotomy During Delivery or Childbirth:
The following ways should follow to avoid tearing during labor and delivery: 

1. Birth Position:
Research indicates that upright (standing, squatting, on all-fours) or lateral (side-lying) positions lead to fewer lacerations.

2. Good Nutrition:
Taking good nutrition throughout your pregnancy—skin becomes healthy and hydrated that can keep the perineum in good shape and thereby reduce the risk of the surgical cut.

3. Pelvic Floor Exercise:
With your doctor or midwife’s approval, do squats, kegels exercise and other core work to support your birth. Exercise is ideal in preparation for an episiotomy-free birth. Squats and kegal exercise help to build the muscles strong in the perineal area and reduce the chance of tearing.

4. Mother-led Pushing:

A slowed second echelon of labor (pushing phase) where pushing is led by the mother (rather than the doctor) in a controlled manner rather than forced, allows more time for your skin to stretch.

5. Perineal Massage:
Perineal massage should begin as early as 34 weeks pregnant. Perineal massage helps to stretch vagina gently during labor as opposed to tearing or getting cut. Midwives instruct mom, how to do this. Generally, Vitamin E, lube or cocoa butter is used to lubricant the perineum, and thumbs are placed about an inch or so within the vagina.

6. Perineal Support:
During the second stage of labor, nurse midwives provide manual perineal support with their hand to reduce the chance of a tear.

7. Warm Compress:
A warm compress during the second echelon of labor is associated with a reduced rate of third-degree and fourth-degree lacerations. The warm, moist compression will encourage relaxation in the area and will help the thin, tender skin to stretch during childbirth.

8. Oil and Massage in Labor:
Some midwives also apply oil to the perineal area, usually sweet almond oil, mineral oil, olive oil or Vitamin E to help encourage relaxation and stretching. Sometimes a husband, partner or birth support person can do this with instruction and support from midwife or doctor as well.

9. Water Birth:
Water births become increasingly popular options for pregnant mothers. The relaxing nature of the water and the buoyancy just looks to be a natural pain-reliever. Now studies show that laboring in a pool reduces the risk of tear or need of an episiotomy.

10. Avoid Use of Epidural:
When an epidural is administered, women cannot move freely and make many of the best birthing positions impossible. Epidurals eliminate natural sensations, so that woman will have to push when someone tells, not when your body feels ready.it has also many side effects show during the birth of baby such as a severe headache, low blood pressure, shivering, vomiting, numbness etc. If possible, a woman should avoid getting an epidural if she expects a cut-free birth.

11. Skilled Midwife:
Midwives always respect the normal speed and flow of labor. Midwives are always spending more time instructing patients on care as well as learning about them and their birth choices. Midwives are also devoted to avoiding unnecessary interventions of all kinds, which are liable to lead to episiotomies or even C-sections.

12. Breathing and Relaxation Exercise:
Most of the woman has fear of labor. But practice breathing exercises regularly, labor won’t be such huge battle.Deep breathing help to stay calm and keep focused during labor. Breathing exercise prevents unhealthy breathing such as hyperventilation or holding your breath, which can lead to fatigue and dizziness. It will allow managing contractions and labor pain better.

13. Walk Around and Move in Labor:
Walking or standing is likely to keep labor moving along as well. During walking, gravity uses excellently and encourage the descent of baby.it help to reduce a backache and may speed labor.

14. Do Not Rush Labor:

There are some women who feel the urge to push as hard as they can as soon as they are fully dilated, but it’s better to take delivery slowly in order to protect the perineum.

More questions related to this article:
  1. Define episiotomy.
  2. What is mean by episiotomy?
  3. How can I avoid an episiotomy or tearing during labor and delivery?
  4. How can I prevent episiotomy or tear during childbirth?
  5. Mention some tips for normal delivery without stitches.
  6. What can you do to prevent tearing during labor?
  7. When should you start doing perineal massage?
  8. Does perineal massage prevent tearing?
  9. How do you massage your perineum before giving birth?
  10. How can I prevent episiotomy?