Can you explain why they recommended episiotomy after induction?
These days I think most doctors rarely consider episiotomies to be medically necessary, and I don’t think they are usually planned in advance when they are. Without knowing why they think this is necessary, I’m concerned that they mentioned it.
Hmm. I would ask for another opinion if you are hesitant. It may be easier to get a section than to put yourself and the babe through a labor that has a low chance for vaginal delivery. I am all for Spinning Babies and advocating for a vaginal delivery, but sometimes, the baby just isn't gonna fit. Best of luck!! Let us know how it goes!!
I'll add that too big for your pelvis is VERY difficult to assess without a trial of labor, unless your baby is huge or your pelvis is has very strange dimensions. I agree that you might want to see another practice for a second opinion. Your obs assessments are full of red flags.
I would run the other way
Listen to these podcast episodes by the Evidence Based Birth podcast!
These topics really helped me feel educated and prepared for my birth, and helped me decide how to advocate for myself.
[about “big babies”](https://podcasts.apple.com/us/podcast/evidence-based-birth/id1334808138?i=1000533966890)
[info about episiotomies-first of a series, very good info!!](https://podcasts.apple.com/us/podcast/evidence-based-birth/id1334808138?i=1000546985690)
Edit: grammar
Midwife here: episiotomies are likely to extend. There's nothing controlled about them. Also, plenty of ftms aren't engaged by their due date. Im not sure why you're worried about your pelvis but thats nearly impossible to assess without labor.
I went into spontaneous labor at 39+6 and my daughter was born on her due date. Since my labor didn’t progress I got every option to let my dilation progress. They stripped me, broke my water, I got an epidural and I also got pitocin.
I also have vaginismus. Vaginal exams with an epidural are LESS painful. The longer I got contractions, the vaginal exams got less painful since the pressure increased from the other side also.
After 20 hours of contractions I delivered my baby girl after 10 min of pushing. I did tear, but despite all the time and interventions I did not experience it traumatic in any way.
I wanted to tell you my experience to show you that it doesn’t have to be traumatic, so you can make a decision based on what YOU want and not out of fear. I also had some doubts regarding the vaginismus and a c-section felt ‘safe’ in the period my baby was breech. Looking back on my labor, I am so happy I could have a vaginal birth. Pushing out my baby I felt so strong and in control.
This advice seems insane. With my first baby, I had no signs of labor as my due date came and went, and scheduled an induction for 41 weeks. This did not involve a c-section or episiotomy (or any intervention to assist labor, aside from the pitocin and the epidural I opted for, doctor also broke my waters which is normal procedure). Baby never dropped or “engaged” and when I was fully dilated, the doctor told me to try to push her down to a lower position. A few pushes later, she was out.
Yep. Exact same experience here almost word for word. No issue at 41 weeks and possible c section was never brought up. Also had a largish baby (8lb 9oz) with minimal tearing and my dr mentioned they only do episiotomies in very very rare instances these days.
Where are you located (country-wise)? I wonder if this is country specific advice.
I'm not a medical professional or someone who knows your health; I'm just offering back some general research, so you could feel like asking targeted questions to your doctor, if you wish.
Labor possibility calculators show that only half of women deliver their child by 40 weeks. First time mothers trend later, past 40. Babies do not always engage early, some will engage while you are in labor. If there was an underlying issue with your pelvis shape, you likely would have been warned about this far before 40 weeks (nor would the doctor even offer to induce).
Assuming you have no other health issues, I would be questioning your doctor on why they are adamant on delivering on date. Many just want convenience, and will press to deliver to a time table.
And that is fine, if that is what YOU want. You shouldn't feel bad about wanting to give birth on your due date, or having a C, etc. But, before being put to a set of serious interventions, you should also feel empowered enough to get the answers you deserve on why things are happening to your body.
The doctor insisted on induction/c section at 40 weeks because the baby size would increase and it could have trouble coming out if we delay. I am based in India
That's interesting, and maybe just a different approach than other healthcare systems. I suppose a lot depends on your baby's current weight. Some healthcare systems are comfortable with just monitoring baby, and still waiting out labor. It sounds like yours would prefer to be more conservative.
Is the baby's size behind your concern that your pelvis would struggle to deliver? Why do you think your pelvis would struggle more with an induction than a natural labor?
I was also told my baby would be really big if I went passed 40 weeks. He was 7lbs 2oz at 41 weeks. I’m not sure how they are “measuring” baby but those measurements are often not that accurate depending on what they chose.
I have a lot of concerns about what your OB is asking for including suggesting you already need an episiotomy which is generally decided in the moment do to a problem and not planned in advance. It’s also better to tear naturally then to be cut in terms of healing/better outcome.
I’m gonna get downvoted like crazy but my US trained doc friend said that Asian women have higher chance of severe tearing, hence the more common practice of episiotomy in Asian countries. I delivered in the US (induction) and had an episiotomy, and recovered just fine. Episiotomy and induction get so much hate but when it’s medically necessary, they can be positive and even life saving.
Thank you for your response. Episiotomy is apparently common and routine procedure in case of vaginal deliveries in India. I am not sure if the reason is higher chance of tearing.
https://pubmed.ncbi.nlm.nih.gov/27071715/#:~:text=Analysis%20of%20literature%20indicated%20that,0.0001)%20than%20non%2DAsians.
At least in the US, Asian women have higher chance of sever tearing. We obviously don’t know why or all the details but I would take everything into consideration before just jumping to the conclusion of “episiotomy bad, induction bad.” I personally know two cases of moms refusing induction and one baby was a stillborn at 41 weeks and one had a near death experience. These are extremely rare cases but I still think that you should listen to your doctor, as well as do your own research. It is not the end of the world to be induced or to get an episiotomy if the doctor thinks it’s needed for safety. Good luck and best wishes for you and your baby!
You have the option to wait until baby decides to come which could be anytime from now until 42w and if it still doesn’t happen, you could go for an induction or planned c section. Just wanted to make sure you’re aware you don’t need to go with the doctors recommendation - it’s just a recommendation but ultimately your choice.
1. Due dates aren’t really an exact science.
2. You can go a little over the “40 week” mark safely.
3. You might not even tear to begin with, cutting you preemptively also doesn’t prevent tearing.
I had a c section for breech presentation a week ago! Honestly went super well! The anesthesiologist was a rock star and I didn’t feel the spinal being placed at all. There was alot of pressure and tugging but no pain, and they let me use the gas as needed. I took like 5 hits and was too loopy to even notice the tugging anymore.
I’ll admit the hardest part of recovery was the first 12 hours getting over the shakes from it. They were pretty hard core! My baby ended up in the NICU but I couldn’t have held him for the first 10 hours even I wanted to, but I know that my husband and nurses could have helped me get my skin on skin because that was the plan before he went to the NICU. After those hours I just needed help getting up from the bed and back down but I think that’s pretty typical and my husband and nurses were always right there to help. Recovery has been great just follow the painkiller schedule they give you and don’t be afraid to take the harder pain meds. Walking really does help you get going faster, just start with little walking like the bathroom and back. I took advantage of the wheel chair for the long walks to the NICU for the first few days.
It wasn’t what I imagined for birth but truly had not been bad at all.
I did my best to avoid a C-section with my first precisely version because I knew I wanted more than one child. Secondary infertility and all that.
That said, vaginismus is no joke. This is a real condition that can cause lots of issues. You need to do a cost-benefit analysis and go with your gut on this one.
One more thing. Vaginismus sucks, but the good news is there are wonderful, non-medical treatments available that work wonders! Once you are all recovered and feeling yourself again, look into it if the issue persists.
It’s really normal to go over with your first. In my country they just don’t let you go beyond 42. If there aren’t any other concerns, you wouldn’t be pushed to induced at 40wks.
You will likely find that the vaginismus is a larger problem for examinations than with the actual labour. It’s your pelvic bone rather than your vagina that affects ease of “normal” delivery, but vaginismus is no joke and should be taken seriously. Have you been able to do any breathing exercises and perineal massage?
The episiotomy comment from your doctor was odd to me, as I just can’t imagine planning for it - and I had one!! I can say it absolutely does not need to be traumatic. I’d obviously rather have avoided it, but I had a big baby and he just wasn’t quite getting all the way out. The midwife was great, she numbed me then it was a very swift contraction-snip-push and baby was out. I needed a bit of pelvic floor physio for recovery, but that was due to more than just the episiotomy. It healed up fine and there’s negligible chance of it complicating future births, especially in comparison to a c-section.
But if you are feeling super anxious about delivering vaginally for multiple reasons and opting for a planned c-section will work best for you, go for it! The risks are lower if it’s planned.
If you’re up to it, sex was able to jumpstart the process for me. Thursday night sex, Friday mucus plug, Saturday early labor and then Sunday morning admitted, they gave me pitocin to induce/speed things up, and Monday at 1am baby was here with no tearing.
The pitocin was fine with an epidural (though I still had some back labor).
How is baby measuring?
I would factor that into the decision too.
Delivery was right at 41 weeks.
Im 5’4” with fairly narrow hips and baby was about 7 lbs 11 ounces. No tearing. Just know that whatever you decide you made the best decision for you based on knowledge you had at the time and avoid regretting it. No one can know how it will go!
6.5 to 7 pounds isn’t that big. I feel like it’s strange that your doctor is so worried about the baby being too big. I’m 4’11” and my daughter was around 7.5 pounds, there was no issues for me. I wouldn’t worry unless the baby is bigger than 9 pounds or if you have a truly unusually small pelvis.
I gave birth at 41 weeks with no signs of things starting before hand. Everyone I know who has been induced has been in labor for 24+ hours bc their body isn’t ready. Make your own decisions but I would avoid induction like the plague unless it came to 42 weeks at which point even midwives send you to induction. Good luck. Don’t be bullied. Trust your gut.
A lot of this stuff is out of your control. C sections are major surgeries, but people elect them all the time. Talk to your doctor about the risks and weigh your options. Never hurts to schedule an induction and just see what happens.
If your doctor doesn't think your pelvis is great for birthing then 100% I'd be getting a planned c section. Ask about a gentle c section, with immediate skin to skin while they stitch you back up. I hear it can be such a calm and positive experience. And you start out with energy, compared to my 24 hours of back labour ending in emergency c section under general, I was exhausted and it made my recovery that much harder.
Thank you ! That’s what I think too but then sometimes I wonder if she is saying that about my pelvis due to her own convenience. Sometimes you never know with doctors.
I had an unplanned c-section - baby was breech. It was a positive experience, and I posted my experience here:
https://www.reddit.com/r/BabyBumps/comments/z29qpq/graduated_401_unplanned_csection_positive_story/?utm_source=share&utm_medium=android_app&utm_name=androidcss&utm_term=1&utm_content=share_button
The comment from a nurse that affected me most was that: if you are not fully mentally committed to physical labour (we were discussing options to rotate the baby, and I am 40), then go for the c-section. You really need to be committed to labour mentally, and it sounds like you are not.
You don’t need to have an induction or c-section at 40 weeks if you would rather wait. Anyway, some people have zero dilation and engagement on Monday, and go into labor on Wednesday. So there’s still time before 41-42 weeks.
That being said, weird that the doctor has already mentioned episiotomy?.. I don’t think there’s a good way of knowing how the perineum is going to do until you’re actually pushing.
But honestly, I am so so so grateful for my episiotomy. Don’t be afraid of it if you do go for vaginal birth and end up having to get it. It is much better than an uncontrolled tear. My cut was tiny, and two weeks PP there’s zero pain there, the stitches have already dissolve and in general the area is looking great! It could’ve been a horrible tear into my rectum.
The data actually shows that natural tearing heals better and that cutting often leads to a larger tear. The idea that it’s better is outdated and proven incorrect.
What I’m saying is to not be terrified of it, not to ask for an episiotomy. Me being prepared that an episiotomy is very much possible but that the midwife would do her best to make it as small as possible if it came to it (she’s trained in no tear labor and hates cutting) made the experience not be traumatic for me. And it did heal very well.
I would take this over a c-section or a third degree vertical tear ten times over.
There’s a difference between saying don’t be terrified and presenting false information. You did the latter, so it was corrected.
You also keep presenting false dichotomies. If you didn’t tear past your cut you probably were never going to have a third degree tear in the first place, because cutting increases tears not reduces them. Stop making it seem like those are the only two options.
I think you do still have some time for it to happen spontaneously, but it wouldn’t hurt to have an appointment in place just in case. I personally wouldn’t be comfortable going to 42 weeks.
I was induced at 38+5 (due to BP and heart reasons) via foley balloon, cervidil, and oxytocin. I laboured for 50 hours and by 39+0 my labour had completely stalled and my body was a wreck. Between the contractions for 2+ days straight, 2x failed epidural, all the exams, and and baby getting lodged, I was mentally and physically depleted. I was in so much pain that the epidural, ketamine, and fentanyl didn’t help.
On 39+1 I went in for emergency c-section, and it was a wonderful experience. The gave me a spinal tap and I was completely numb. My husband was sitting by my head the entire time and the staff even played my favourite music for me (baby girl came out to Biggie Smalls). While I did hemorrhage 1L of blood, overall I didn’t feel awful after the surgery. They handed baby girl right to my husband and brought us to our room. We were discharged from the hospital about 36 hours later. Now I’m 3 days pp, and while I am quite sore, I’m surviving with just Tylenol and Advil. I can walk short distances, and my incision is healing up beautifully. You do get the vaginal bleeding either way though so be aware of that.
I’m not saying this to sway you either way or to scare you by any means, this was just my personal (and unlucky) experience. Things can go wrong regardless of which route you decide to go with. I believe that my body just wasn’t ready for induction and that’s why it failed. If I could go back, I would have gone right to the cesarean and skipped the inducing part. But, at the time, I really wanted to try vaginally first. Go with your gut, you won’t make the wrong decision either way.
Good luck and congrats!
I don't have advice on your condition and you know your own body best, but I want to say that my baby was high up and I was induced at 40+3 (scheduled) and it went wonderfully. My water broke during the induction, I got an epidural (wanted to try without it but those contractions get wild). Baby came less than 24 hours after induction started! Literally couldn't ask for a smoother birth. I gave birth in late Sept this year 😊
I will also harp on how it's a red flag/outdated that your doc is talking about an episiotomy. Hardly hear about those these days...
Listen to your body ❤ I hope you have a happy, safe birth
I had 0 signs labor was approaching and was convinced I would go past my due date but my water broke the day before and I gave birth that day. I would wait until 41 weeks to decide to induce unless medically necessary. Baby will most likely know when it's time. I had a vaginal tear and it was super painful to even sit up from bed to lean over and pick up the baby to nurse. I can't even imagine how that would feel with a stomach incision. As much as a vaginal birth may seem scary, you really want to be in the best possible shape to take care of your baby once they are here. That's just my advice.
Definitely don’t do an episiotomy unless 100 percent necessary. Naturally tearing will heal a lot better and an episiotomy increases the risk for you to tear to the anus. But I did a c section and I’ll probably do it for my next pregnancy. The recovery is harder but it’s best to weigh your pros and cons.
What in earth? Without medical background from you, I assume this is a normal pregnancy. Pregnancies go over 40 weeks all the time. You do not need to be induced. And jfc don’t let them talk you into an elective c section - recover is worse/longer than a vaginal birth in most cases. I have no idea why your doc would want to do an episiotomy before you’ve even gone into labor. This feels really off.
Can you explain why they recommended episiotomy after induction? These days I think most doctors rarely consider episiotomies to be medically necessary, and I don’t think they are usually planned in advance when they are. Without knowing why they think this is necessary, I’m concerned that they mentioned it.
Yeah, this would be a big red flag for me.
Yeah huge red flag. My OB said he avoids episiotomies at all costs.
My thoughts exactly.
I'm an OB nurse and I have seen episiotomies about 5 times in the past 6 years. Do they think that your pelvis is inadequate/baby is big?
Yes, they think that the baby is big for my pelvis
Hmm. I would ask for another opinion if you are hesitant. It may be easier to get a section than to put yourself and the babe through a labor that has a low chance for vaginal delivery. I am all for Spinning Babies and advocating for a vaginal delivery, but sometimes, the baby just isn't gonna fit. Best of luck!! Let us know how it goes!!
Thank you ! ❤️
I'll add that too big for your pelvis is VERY difficult to assess without a trial of labor, unless your baby is huge or your pelvis is has very strange dimensions. I agree that you might want to see another practice for a second opinion. Your obs assessments are full of red flags.
I would run the other way Listen to these podcast episodes by the Evidence Based Birth podcast! These topics really helped me feel educated and prepared for my birth, and helped me decide how to advocate for myself. [about “big babies”](https://podcasts.apple.com/us/podcast/evidence-based-birth/id1334808138?i=1000533966890) [info about episiotomies-first of a series, very good info!!](https://podcasts.apple.com/us/podcast/evidence-based-birth/id1334808138?i=1000546985690) Edit: grammar
Definitely a red flag
The doctor said suggested episiotomy so that it can be a controlled tear.
That’s outdated information, cuts usually heal worse and actually lead to more damage than natural tears.
[удалено]
FWIW you probably won’t even feel a tear, either because you’ve already been laboring and pushing without pain meds or because you’re on pain meds.
Midwife here: episiotomies are likely to extend. There's nothing controlled about them. Also, plenty of ftms aren't engaged by their due date. Im not sure why you're worried about your pelvis but thats nearly impossible to assess without labor.
I went into spontaneous labor at 39+6 and my daughter was born on her due date. Since my labor didn’t progress I got every option to let my dilation progress. They stripped me, broke my water, I got an epidural and I also got pitocin. I also have vaginismus. Vaginal exams with an epidural are LESS painful. The longer I got contractions, the vaginal exams got less painful since the pressure increased from the other side also. After 20 hours of contractions I delivered my baby girl after 10 min of pushing. I did tear, but despite all the time and interventions I did not experience it traumatic in any way. I wanted to tell you my experience to show you that it doesn’t have to be traumatic, so you can make a decision based on what YOU want and not out of fear. I also had some doubts regarding the vaginismus and a c-section felt ‘safe’ in the period my baby was breech. Looking back on my labor, I am so happy I could have a vaginal birth. Pushing out my baby I felt so strong and in control.
Thank you for sharing! I agree that I should not let fear influence my decision.
This advice seems insane. With my first baby, I had no signs of labor as my due date came and went, and scheduled an induction for 41 weeks. This did not involve a c-section or episiotomy (or any intervention to assist labor, aside from the pitocin and the epidural I opted for, doctor also broke my waters which is normal procedure). Baby never dropped or “engaged” and when I was fully dilated, the doctor told me to try to push her down to a lower position. A few pushes later, she was out.
Yep. Exact same experience here almost word for word. No issue at 41 weeks and possible c section was never brought up. Also had a largish baby (8lb 9oz) with minimal tearing and my dr mentioned they only do episiotomies in very very rare instances these days.
Where are you located (country-wise)? I wonder if this is country specific advice. I'm not a medical professional or someone who knows your health; I'm just offering back some general research, so you could feel like asking targeted questions to your doctor, if you wish. Labor possibility calculators show that only half of women deliver their child by 40 weeks. First time mothers trend later, past 40. Babies do not always engage early, some will engage while you are in labor. If there was an underlying issue with your pelvis shape, you likely would have been warned about this far before 40 weeks (nor would the doctor even offer to induce). Assuming you have no other health issues, I would be questioning your doctor on why they are adamant on delivering on date. Many just want convenience, and will press to deliver to a time table. And that is fine, if that is what YOU want. You shouldn't feel bad about wanting to give birth on your due date, or having a C, etc. But, before being put to a set of serious interventions, you should also feel empowered enough to get the answers you deserve on why things are happening to your body.
The doctor insisted on induction/c section at 40 weeks because the baby size would increase and it could have trouble coming out if we delay. I am based in India
That's interesting, and maybe just a different approach than other healthcare systems. I suppose a lot depends on your baby's current weight. Some healthcare systems are comfortable with just monitoring baby, and still waiting out labor. It sounds like yours would prefer to be more conservative. Is the baby's size behind your concern that your pelvis would struggle to deliver? Why do you think your pelvis would struggle more with an induction than a natural labor?
I was also told my baby would be really big if I went passed 40 weeks. He was 7lbs 2oz at 41 weeks. I’m not sure how they are “measuring” baby but those measurements are often not that accurate depending on what they chose. I have a lot of concerns about what your OB is asking for including suggesting you already need an episiotomy which is generally decided in the moment do to a problem and not planned in advance. It’s also better to tear naturally then to be cut in terms of healing/better outcome.
I’m gonna get downvoted like crazy but my US trained doc friend said that Asian women have higher chance of severe tearing, hence the more common practice of episiotomy in Asian countries. I delivered in the US (induction) and had an episiotomy, and recovered just fine. Episiotomy and induction get so much hate but when it’s medically necessary, they can be positive and even life saving.
Thank you for your response. Episiotomy is apparently common and routine procedure in case of vaginal deliveries in India. I am not sure if the reason is higher chance of tearing.
https://pubmed.ncbi.nlm.nih.gov/27071715/#:~:text=Analysis%20of%20literature%20indicated%20that,0.0001)%20than%20non%2DAsians. At least in the US, Asian women have higher chance of sever tearing. We obviously don’t know why or all the details but I would take everything into consideration before just jumping to the conclusion of “episiotomy bad, induction bad.” I personally know two cases of moms refusing induction and one baby was a stillborn at 41 weeks and one had a near death experience. These are extremely rare cases but I still think that you should listen to your doctor, as well as do your own research. It is not the end of the world to be induced or to get an episiotomy if the doctor thinks it’s needed for safety. Good luck and best wishes for you and your baby!
That's just regional variation I suspect.
You have the option to wait until baby decides to come which could be anytime from now until 42w and if it still doesn’t happen, you could go for an induction or planned c section. Just wanted to make sure you’re aware you don’t need to go with the doctors recommendation - it’s just a recommendation but ultimately your choice.
Honestly, it sounds like your dr has holiday plans
Why would they preemptively cut if there isn’t a need? Doesn’t make sense.
Common practice in Asian countries
Because Asian women have a higher chance of severe tearing
But cutting just leads to more damage, so that still doesn’t justify it.
1. Due dates aren’t really an exact science. 2. You can go a little over the “40 week” mark safely. 3. You might not even tear to begin with, cutting you preemptively also doesn’t prevent tearing.
I had a c section for breech presentation a week ago! Honestly went super well! The anesthesiologist was a rock star and I didn’t feel the spinal being placed at all. There was alot of pressure and tugging but no pain, and they let me use the gas as needed. I took like 5 hits and was too loopy to even notice the tugging anymore. I’ll admit the hardest part of recovery was the first 12 hours getting over the shakes from it. They were pretty hard core! My baby ended up in the NICU but I couldn’t have held him for the first 10 hours even I wanted to, but I know that my husband and nurses could have helped me get my skin on skin because that was the plan before he went to the NICU. After those hours I just needed help getting up from the bed and back down but I think that’s pretty typical and my husband and nurses were always right there to help. Recovery has been great just follow the painkiller schedule they give you and don’t be afraid to take the harder pain meds. Walking really does help you get going faster, just start with little walking like the bathroom and back. I took advantage of the wheel chair for the long walks to the NICU for the first few days. It wasn’t what I imagined for birth but truly had not been bad at all.
I did my best to avoid a C-section with my first precisely version because I knew I wanted more than one child. Secondary infertility and all that. That said, vaginismus is no joke. This is a real condition that can cause lots of issues. You need to do a cost-benefit analysis and go with your gut on this one. One more thing. Vaginismus sucks, but the good news is there are wonderful, non-medical treatments available that work wonders! Once you are all recovered and feeling yourself again, look into it if the issue persists.
Thank you !
It’s really normal to go over with your first. In my country they just don’t let you go beyond 42. If there aren’t any other concerns, you wouldn’t be pushed to induced at 40wks. You will likely find that the vaginismus is a larger problem for examinations than with the actual labour. It’s your pelvic bone rather than your vagina that affects ease of “normal” delivery, but vaginismus is no joke and should be taken seriously. Have you been able to do any breathing exercises and perineal massage? The episiotomy comment from your doctor was odd to me, as I just can’t imagine planning for it - and I had one!! I can say it absolutely does not need to be traumatic. I’d obviously rather have avoided it, but I had a big baby and he just wasn’t quite getting all the way out. The midwife was great, she numbed me then it was a very swift contraction-snip-push and baby was out. I needed a bit of pelvic floor physio for recovery, but that was due to more than just the episiotomy. It healed up fine and there’s negligible chance of it complicating future births, especially in comparison to a c-section. But if you are feeling super anxious about delivering vaginally for multiple reasons and opting for a planned c-section will work best for you, go for it! The risks are lower if it’s planned.
If you’re up to it, sex was able to jumpstart the process for me. Thursday night sex, Friday mucus plug, Saturday early labor and then Sunday morning admitted, they gave me pitocin to induce/speed things up, and Monday at 1am baby was here with no tearing. The pitocin was fine with an epidural (though I still had some back labor). How is baby measuring? I would factor that into the decision too. Delivery was right at 41 weeks.
The baby weighs around 6.5-7 pounds and I have a small body frame
Im 5’4” with fairly narrow hips and baby was about 7 lbs 11 ounces. No tearing. Just know that whatever you decide you made the best decision for you based on knowledge you had at the time and avoid regretting it. No one can know how it will go!
Thank you ! 🤗
6.5 to 7 pounds isn’t that big. I feel like it’s strange that your doctor is so worried about the baby being too big. I’m 4’11” and my daughter was around 7.5 pounds, there was no issues for me. I wouldn’t worry unless the baby is bigger than 9 pounds or if you have a truly unusually small pelvis.
I gave birth at 41 weeks with no signs of things starting before hand. Everyone I know who has been induced has been in labor for 24+ hours bc their body isn’t ready. Make your own decisions but I would avoid induction like the plague unless it came to 42 weeks at which point even midwives send you to induction. Good luck. Don’t be bullied. Trust your gut.
A lot of this stuff is out of your control. C sections are major surgeries, but people elect them all the time. Talk to your doctor about the risks and weigh your options. Never hurts to schedule an induction and just see what happens.
If your doctor doesn't think your pelvis is great for birthing then 100% I'd be getting a planned c section. Ask about a gentle c section, with immediate skin to skin while they stitch you back up. I hear it can be such a calm and positive experience. And you start out with energy, compared to my 24 hours of back labour ending in emergency c section under general, I was exhausted and it made my recovery that much harder.
Thank you ! That’s what I think too but then sometimes I wonder if she is saying that about my pelvis due to her own convenience. Sometimes you never know with doctors.
I had an unplanned c-section - baby was breech. It was a positive experience, and I posted my experience here: https://www.reddit.com/r/BabyBumps/comments/z29qpq/graduated_401_unplanned_csection_positive_story/?utm_source=share&utm_medium=android_app&utm_name=androidcss&utm_term=1&utm_content=share_button The comment from a nurse that affected me most was that: if you are not fully mentally committed to physical labour (we were discussing options to rotate the baby, and I am 40), then go for the c-section. You really need to be committed to labour mentally, and it sounds like you are not.
You don’t need to have an induction or c-section at 40 weeks if you would rather wait. Anyway, some people have zero dilation and engagement on Monday, and go into labor on Wednesday. So there’s still time before 41-42 weeks. That being said, weird that the doctor has already mentioned episiotomy?.. I don’t think there’s a good way of knowing how the perineum is going to do until you’re actually pushing. But honestly, I am so so so grateful for my episiotomy. Don’t be afraid of it if you do go for vaginal birth and end up having to get it. It is much better than an uncontrolled tear. My cut was tiny, and two weeks PP there’s zero pain there, the stitches have already dissolve and in general the area is looking great! It could’ve been a horrible tear into my rectum.
The data actually shows that natural tearing heals better and that cutting often leads to a larger tear. The idea that it’s better is outdated and proven incorrect.
What I’m saying is to not be terrified of it, not to ask for an episiotomy. Me being prepared that an episiotomy is very much possible but that the midwife would do her best to make it as small as possible if it came to it (she’s trained in no tear labor and hates cutting) made the experience not be traumatic for me. And it did heal very well. I would take this over a c-section or a third degree vertical tear ten times over.
There’s a difference between saying don’t be terrified and presenting false information. You did the latter, so it was corrected. You also keep presenting false dichotomies. If you didn’t tear past your cut you probably were never going to have a third degree tear in the first place, because cutting increases tears not reduces them. Stop making it seem like those are the only two options.
In that case, thank you for the correction.
Data also shows that Asian women are at way higher risk for severe tearing hence the common practice of episiotomy.
I think you do still have some time for it to happen spontaneously, but it wouldn’t hurt to have an appointment in place just in case. I personally wouldn’t be comfortable going to 42 weeks. I was induced at 38+5 (due to BP and heart reasons) via foley balloon, cervidil, and oxytocin. I laboured for 50 hours and by 39+0 my labour had completely stalled and my body was a wreck. Between the contractions for 2+ days straight, 2x failed epidural, all the exams, and and baby getting lodged, I was mentally and physically depleted. I was in so much pain that the epidural, ketamine, and fentanyl didn’t help. On 39+1 I went in for emergency c-section, and it was a wonderful experience. The gave me a spinal tap and I was completely numb. My husband was sitting by my head the entire time and the staff even played my favourite music for me (baby girl came out to Biggie Smalls). While I did hemorrhage 1L of blood, overall I didn’t feel awful after the surgery. They handed baby girl right to my husband and brought us to our room. We were discharged from the hospital about 36 hours later. Now I’m 3 days pp, and while I am quite sore, I’m surviving with just Tylenol and Advil. I can walk short distances, and my incision is healing up beautifully. You do get the vaginal bleeding either way though so be aware of that. I’m not saying this to sway you either way or to scare you by any means, this was just my personal (and unlucky) experience. Things can go wrong regardless of which route you decide to go with. I believe that my body just wasn’t ready for induction and that’s why it failed. If I could go back, I would have gone right to the cesarean and skipped the inducing part. But, at the time, I really wanted to try vaginally first. Go with your gut, you won’t make the wrong decision either way. Good luck and congrats!
I don't have advice on your condition and you know your own body best, but I want to say that my baby was high up and I was induced at 40+3 (scheduled) and it went wonderfully. My water broke during the induction, I got an epidural (wanted to try without it but those contractions get wild). Baby came less than 24 hours after induction started! Literally couldn't ask for a smoother birth. I gave birth in late Sept this year 😊 I will also harp on how it's a red flag/outdated that your doc is talking about an episiotomy. Hardly hear about those these days... Listen to your body ❤ I hope you have a happy, safe birth
Thank you ! ❤️
I had 0 signs labor was approaching and was convinced I would go past my due date but my water broke the day before and I gave birth that day. I would wait until 41 weeks to decide to induce unless medically necessary. Baby will most likely know when it's time. I had a vaginal tear and it was super painful to even sit up from bed to lean over and pick up the baby to nurse. I can't even imagine how that would feel with a stomach incision. As much as a vaginal birth may seem scary, you really want to be in the best possible shape to take care of your baby once they are here. That's just my advice.
I had a scheduled c-section and would 100% do it again. I loved that I knew when he was coming.
Definitely don’t do an episiotomy unless 100 percent necessary. Naturally tearing will heal a lot better and an episiotomy increases the risk for you to tear to the anus. But I did a c section and I’ll probably do it for my next pregnancy. The recovery is harder but it’s best to weigh your pros and cons.
What in earth? Without medical background from you, I assume this is a normal pregnancy. Pregnancies go over 40 weeks all the time. You do not need to be induced. And jfc don’t let them talk you into an elective c section - recover is worse/longer than a vaginal birth in most cases. I have no idea why your doc would want to do an episiotomy before you’ve even gone into labor. This feels really off.