Breaking; Episiotomy: Overview, Indications and Recommendations…..

The process of child birth can go smoothly for most women, however for some women, they will require assistance to ensure safe delivery.
Episiotomy, once upon a time used to be a routine part of childbirth.

Currently episiotomy is now recommended only in certain cases of childbirth. It is very important to understand the risks, benefits and recovery of this surgical procedure.

#What is Episiotomy?

This is an intervention based mini surgical procedure made in the area of tissue between the vagina and the anus. The aim of this procedure is to aid smooth delivery of the baby. This procedure is mainly used during childbirth if the tissue aforementioned begins to tear or is not expanding enough for delivery. After delivery, the incision is closed with sutures that can be absolved by the body, without needing removal manually.

#Origin of Episiotomy
Prior to now, an episiotomy was normally believed to help prevent more extensive vaginal tears during childbirth. It was also theorized that it heals better than a natural tear. This procedure was also thought to help preserve the muscular and connective tissue support of the pelvic floor (the base of the female reproductive parts).

Luckily today, however, research suggests that routine episiotomies don’t prevent these problems after all.

The truth is sometimes recovery from episiotomy is uncomfortable, and sometimes the surgical incision is more extensive than a natural tear would have been. Infection is also possible. For some women, an episiotomy causes pain during sex in the months after delivery. An extensive episiotomy might also contribute to fecal incontinence after childbirth.

#New approach/ Practice

Routine episiotomies are no longer recommended. However this procedure is still warranted in some cases.

Your doctor might recommend an episiotomy if:

1. Extensive vaginal tearing appears likely
2. Your baby is in an abnormal position
3. Your baby is large (fetal macrosomia)
4. Your baby needs to be delivered quickly

Please, note if you need an episiotomy and you haven’t had any type of anesthesia or the anesthesia has worn off, you’ll likely receive an injection of a local anesthetic to numb the tissue. You shouldn’t feel your health care provider making the incision or repairing it after delivery.

#Types

There are two types of episiotomy incisions:

1. Mid-line or median incision. A mid line or median incision is done vertically. A mid line incision is the easiest to repair, but has a higher risk of extending into the anal area.

2.Mediolateral incision. A mediolateral incision is done at an angle. A mediolateral incision offers the best protection from an extended tear affecting the anal area, but is often more painful and might be more difficult to repair.

#The Healing Process

The healing of episiotomy takes time. Please if you got an episiotomy or tear during delivery, be informed the wound might hurt for a few weeks especially when you walk or sit. It is important you give your surgical wound and area the required time for healing. If the incision or tear is extensive, the pain might last longer. Any stitches used to repair the episiotomy will usually be absorbed on their own.

#Recommendations

Please consider the following remedies:

1. Soothe the wound. Cool the wound with an ice pack, or cool pad /sanitary napkin

2. Be careful while urinating, avoid straining.

3. Prevent pain and stretching during bowel movements. Press a clean pad against the wound when passing a bowel movement.

4. Sit down carefully. Tighten your buttocks as you lower yourself to a seated position. Sit on a pillow or padded ring.

5. Use medication as needed. Your health care provider might order prescription medications or recommend an over-the-counter pain reliever or stool softener.

6. Consider complementary treatments. Some research suggests that lavender might help relieve pain after a tear or episiotomy. If your health care provider approves, add a few drops of lavender essential oil to your bath water or apply the oil directly to the tissue between your vaginal opening and your anus.

#Afterthoughts

While you’re healing, expect the discomfort to progressively improve.
Contact your health care provider if the pain intensifies, you develop a fever or the wound produces a pus-like discharge. These could be signs of an infection.

Dr Godsons Chukwudi Ufondu