How to avoid an incision during childbirth

Epiotiotomy and perineotomy in childbirth are completely optional, childbirth without incisions is still carried out much more often than with it. In order to minimize the possibility of an incision during childbirth, it is very important to properly prepare for the birth process.

It is very good if during pregnancy a woman will attend special classes for women in childbirth, in which she learns about what awaits her during childbirth, about various breathing techniques for pain relief and relaxation during contractions and delivery.

These manipulations reduce the likelihood of various artificial interventions in the natural process of childbirth.

According to the statistics of childbirth, there are practically no complications without complications, however, medicine does not stand still and doctors are making every effort to minimize possible complications in childbirth for mothers and children. One of these procedures is an incision during childbirth of the perineum and posterior wall of the vagina to avoid tearing in the woman in labor and craniocerebral herbs during childbirth.

When a cut is needed during childbirth

Cuts during childbirth are carried out according to the following main indications:

1. Too large fruit;
2. The elasticity of the walls of the vagina is very low, which prevents the passage of the baby’s head;
3. Too fast exit of the baby’s head;
4. Long period of attempts;
5. High risk of rupture of perineal tissue;
6. In the case of premature birth to prevent strong compression of the tissue of the perineum by the fragile bones of the skull of the fetus;
7. Oxygen starvation of the fetus, the incision reduces the compression of the fetal head by the muscles of the perineum and the birth process is accelerated;
8. Instrumental obstetrics, that is, the use of forceps or a vacuum extractor;
9. Gluteal presentation of the fetus, which complicates the birth of the head after smaller buttocks.

In all the cases described above, doctors recommend that a woman in labor give an incision during childbirth to avoid rupture of perineal tissue. Since the healing of such gaps takes a long time and it is difficult for obstetricians to give preference in the case of a critical situation to the product of the incision.

The main differences between spontaneous rupture and surgical incision are:

• Wounds with smooth edges heal much faster than lacerations.
• Sutures applied to a neat incision heal faster.
• Surgical incisions are less susceptible to suppuration and inflammatory processes.
• After healing, such an incision looks more aesthetic.
• With a natural rupture, it is possible to injure the rectum or clitoris, with a surgical doctor, the cut depth is accurately calculated

Incisions during childbirth. Section Views

The perineal incision during childbirth is always due to serious reasons, depending on which the doctor will choose one of two types of incisions.

• Perineotomy – this section during childbirth is performed along the midline, directed to the rectum.
• Episiotomy – with this section, the incision is directed to the side.

When deciding on a dissection method during childbirth, the obstetrician takes into account the individual structure and possible pathologies of the perineum, the size of the fetus, and the course of labor.

Usually, an indication for perineotomy is a high probability of rupture of the perineum during the normal course of childbirth, due to the too large distance between the posterior commissure of the labia majora and the anus. Also, this type of incision is used if delivery occurs prematurely.

The causes of episiotomy are broader:

1. “Low” perineum in women in labor;
2. Acute angle of convergence of the pubic joint bones;
3. Gluteal presentation of the fetus;
4. Scars on the perineum;
5. Instrumental birth.

How to make an incision during childbirth

Cuts during childbirth by a doctor are usually carried out before the birth of the baby’s head. To do this, special scissors are used by the obstetrician, less often a scalpel, the doctor cuts the stretched skin and subcutaneous tissue five to eight centimeters down, possibly a little to the side. When a doctor makes an incision during childbirth, the woman does not feel pain, since the head of the newborn stretches the perineal tissues very much, which leads to their numbness.

Unlike dissection of the perineum, suturing after it or after rupture can be very painful, so local anesthesia is often used. After the procedure, the incision after childbirth in a woman causes discomfort and very severe pain, in some situations inflammation can occur. The perineal incision after childbirth heals after a few months, and the suture material resolves. In order for the incision after childbirth to heal as soon as possible, a woman can undergo physiotherapy, ultrasound, and local disinfection.

The healing time of the sutures largely depends on the proper care of the wound and strict adherence to the recommendations of the doctor. In addition, each woman has her own individual regenerative abilities, do not forget about “sexual purity”, that is, the presence of sexual infections in a woman. Therefore, the healing period is individual, the question of the onset of sexual relations must be agreed with the attending physician.

Sutures and an incision after childbirth for some time bring discomfort to a woman in the perineum and genitals, however this sensation quickly disappears.

How to care for stitches after an incision

Caring for a suture after a perineal incision during childbirth is not difficult, however, it is very important to take this care very seriously, as this poses a huge threat to the further health of a woman.

Basic requirements for postpartum suture care:

• Immediately after childbirth and in the next two weeks, a woman is strictly forbidden to sit down, moreover, it is also necessary to sit half-sitting in the toilet.
• Two weeks later, a woman is allowed to sit briefly on the buttock, which is located on the opposite side to the incision and only on a hard surface. If this recommendation is neglected, then the seams may break.
• It is very important to monitor the stool and prevent constipation, so foods that normalize stool should be present in the diet.
• Hygiene is very important – after each bowel movement, the genitals should be rinsed with warm water and slightly blotted with a well-absorbing cloth.
• In the morning and evening, the seams should be treated with hydrogen peroxide, and after that – with green. In the hospital, these procedures should be performed by a nurse. Sometimes doctors recommend instead of alcohol cauterization, as often as possible, allow the joints to dry naturally – in the open air, for this at least half an hour a day should not wear underwear, and lie down on a clean diaper.
• Accelerates the healing of joints and increased blood circulation in the incision area, this is achieved during movement and walking.
• The right selection of personal care products is very important. So doctors recommend not using special gels for care, but pure warm water. During washing, movements should be carried out from the perineum towards the anus, and in no case vice versa, so as not to bring the infection into the genital tract.
• Regardless of the filling of sanitary pads, they should be changed at least every three hours.
• Women who underwent an incision during childbirth should not wear a bandage or lingerie, as it disrupts normal blood circulation, and, therefore, slows the healing of sutures.
• In the event that a woman has any discomfort – severe pain, throbbing in the joints, swelling, unpleasant odor, burning or itching, it is necessary to consult a gynecologist.

How to avoid an incision during childbirth

The probability of gaps in women during childbirth increases many times if childbirth is swift or artificial stimulation of labor was carried out. But if a woman in labor during pregnancy performed special exercises to strengthen the muscles involved in childbirth, then it is more likely that childbirth will take place without cuts and gaps.

Incisions during childbirth can be completely excluded if we engage in their prevention. This requires a special massage of the perineum, due to which:

1. Blood circulation improves, metabolism in perineal tissues accelerates, thus, their elasticity increases,
2. The muscles of the perineum are trained for proper relaxation during labor.
3. The likelihood of episiotomy and perineotomy is reduced,
4. If a woman has already given birth, then the muscles in the perineum can become less elastic, and no matter what the gap occurs, it is massage that helps restore muscle elasticity.

Massage should begin to be done from 33-34 weeks of gestation, the pattern is approximately the following:

• 33 – 35 weeks – once every three days,
• 36 – 37 weeks – every other day,
• From 38 weeks – daily.

If a woman learned about the need for massage shortly before delivery, it’s not scary; it’s never too late to start it.

For massage, you can use a special massage or cosmetic oil, for example, olive or coconut, but using creams, lotions with alcohol or synthetic oils is undesirable.

It is very important that the massage procedure does not bring a woman discomfort, but rather that it is pleasant for a woman.

Massage technique

The best time for a massage is evening, before it should take a warm shower, to relax the body. Wash your hands before the procedure.

1. It is necessary to take an upright position, and put one leg on a chair.
2. Lubricate the labia and perineum with massage oil, introduce two fingers greased with oil two to three centimeters into the vagina.
3. To relax the vaginal muscles and moving towards the anus to carry out motor movements in the vagina. The pace of movement should be constantly changing.
4. After, with swaying movements, press on the back wall of the vagina until muscle tension is felt, continue for 30-60 seconds, then relax and repeat again.
5. Then, for 60 seconds, massage the skin of the perineum with the index and thumb, the large is located inside the vagina, the index on the perineum,
6. All exercises are repeated anew over seven minutes.

It is important to know that massage has contraindications, these include:

• The threat of premature delivery,
• The presence of any diseases of the genital tract, especially fungal and infectious, as massage can trigger an exacerbation of the disease. In this case, it is first necessary to carry out appropriate treatment.