WAYS TO AVOID EPISIOTOMY AND HEALING HINTS
Perform
prenatal perineal massage. With your doctor's okay, start about six weeks
before your due date. Here's how: Sit up, leaning back, in bed, or stand with a
foot resting on a chair. Lubricate your fingers with vegetable oil or a
water-soluble gel like K-Y Jelly. With your thumbs on the inside and other
fingers on the outside, make a U-shaped movement around the bottom portion of
your vagina (the part toward your back). For about five minutes, apply just
enough pressure to create a stinging sensation while you focus on relaxing.
Your partner could also do this massage for you, with index fingers inside and
thumbs outside.
Control your
pushing. During the birth, you can help by controlling your pushing according
to your birth attendant's directions, by letting your knees fall far apart, and
by completely relaxing your pelvic floor muscles (the opposite of a Kegel).
Your doctor or midwife may apply warm compresses to help you relax, topical
lubricants to ease out the baby's head, and firm hand pressure to keep the
baby's chin flexed to present a smaller diameter at birth.
HAVING A SECOND CHILD
Once you've
had a baby, you're more likely to avoid an episiotomy the next time. If the
vaginal area has been stretched once, it should stretch more easily with less
tearing for subsequent deliveries, according to Cynthia Hanna, MD, an assistant
clinical professor in obstetrics and gynecology at Brown University. And even
though the scar tissue from an old episiotomy isn't as elastic as normal
tissue, a second-time mother can usually stretch enough to accommodate another
baby without tearing badly.
Healing Hints
Whether or
not you had an episiotomy or stitches from a tear, you'll feel sore or swollen
for a few days to weeks after giving birth. Experts say you'll heal faster if
you:
Use an ice
pack for 24 hours, then take frequent warm sitz baths (you should receive one
from the hospital; they're also available at your local pharmacy).
Keep the area
clean and apply witch hazel or a topical anesthetic.
Do frequent
Kegels to improve circulation and speed healing.
Drink lots
of water to keep your urine diluted so it doesn't sting.
Don't sit on
an inner tube to avoid pain -- this pulls stitches apart. Instead, choose a
firm seat and do a Kegel before you sit down.
Don't baby
the area; the sooner you move around, the faster your pain will decrease.
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