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 (May work) (May work) (May work) (May work) (May work) 3.69 (May work) from 22 votes (899 Visits)

Registered Nurses opinion on to cut or tear.

Anonymous Author (July 2006)

Just wondering, what are some people's oppinions when having birth would you rather be cut or let the doctor let you tear. Could you give reasoning. There are lots of people that would go for the cut, and others will go for the tear.. But nobody really gives an explanation...

So if you wouldnt mind, just share your oppinion with me?

A tear is very uncontrolled.  You never know if it's going to be first degree or third degree.  You also don't know where the tear is going to occur and in what direction it will go.  (TMI warning) A tear can be jagged and go straight up to your rectum, with the possibility of tearing inside you rectum as well and can possible be very deep.  If you're luck it will go to the side towards you butt cheek where there is lots of fatty tissu that heal much easier.  I don't want to scare anyone but those are the facts.  If the baby gets stuck and the vaginal opening has not been stretched enough the tear can be very traumatic. 

In an episiotmy (cut) it's controlled and a straight incision.  A tear can happen after an episiotomy but will then follow the direction of the episiotmy therefore much safer and much easier to heal from. 

Here's an example you can picture in your head without getting grossed out.         It's easier to tape a piece of paper together or stitch a piece of material together that has been cut with scissors, than one that has been torn.  A small tear in a piece of paper isn't difficult either but if the cut gets out of control how large or jagged will it be.  It's easier to control the scissors to cut the paper.

I'm the kind of person who likes to have the situation controlled...but remember as a patient you always have the right to refuse.  If you would rather try the stretch method with a possible tear make sure you let your practitioner know!


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ADVICE RATING
 (May work) (May work) (May work) (May work) (May work) 3.69 (May work) from 22 votes
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EmmaBella
5.00 (Excellent) | September 2006 | EmmaBella
Research Realities
Unfortunately your opinion is completely contraindicated by the medical research we now have available. Studies are linked below. Here are the realities of episiotomy:

- Episiotomies do not prevent tears into or through the anal sphincter or vaginal tears. In fact, 3rd & 4th degree tears are more likely to occur after an episiotomy is performed.
- Even when properly repaired, fecal incontinence later in life is more likely with an episiotomy.
- If a woman does not have an episiotomy, she is likely to have a small tear, but with rare exceptions the tear will be, at worst, no worse than an episiotomy.
- Episiotomies do not prevent urinary incontinence
- Episiotomies do not improve sexual satisfaction and have been associated with increased pain during intercourse.
- Episiotomies are not easier to repair than tears and usually require more sutures.
- Episiotomies take longer to heal and are more painful for the mother.
- Episiotomies do not prevent birth injuries or fetal brain damage.
- Episiotomies increase blood loss.
- Episiotomies increase the chance of infection.

http://www.efn.org/~djz/birth/obmyth/epis.html
http://www.changesurfer.com/Hlth/episiotomy.html


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matthew
4.44 (Good) | July 2006 | matthew
Thanks
It's good to have a registered nurse post about this topic - thanks for sharing HazyAmy :)


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allyp
4.67 (Excellent) | July 2006 | allyp
opinion to cut to tear
Lucky for me, I tore but really really small. All i got in the end was 1 stitch. So I think if it was that way(if it was really small tear) i would have tear that be cut.


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kathyv8
4.57 (Excellent) | July 2006 | kathyv8
opinion on to cut or tear
I think that each delivery has the potential to be so different from any other one. Sometimes doctors want to take the "safest" route to avoid legal action and I understand that frame of mind. However, if they were free to listen to the mother, I think there would be a whole lot less intervention. It has taken a while for my doctor to trust my ability to birth in the manner I feel comfortable with, just as i have had to learn to trust his advice when necessary. I think it's harder for the mum to trust the doctor when she is in such a vulnerable state and it is a good idea to learn as much as you can before delivery.


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mrslunar
3.83 (Good) | July 2006 | mrslunar
interesting opinon
However statistics and studies prove time and time again that cuts typically are the types of things that become severe, cuts usually are the cause of the deep tearing you talk about, and that tears heal better than cuts. Scare tactics are just that...........scare tactics but they don't actually follow logic, reason, and science unfortunately.

The medical industry is trained to look at birth just as you mentioned.........something that is "wrong" with a woman and must be managed and controlled. Sadly, is that mentality that birth is to be managed and controlled that leads to problems. Statistically, the vast majority of women with 2nd degree tears or worse had an episiotomy FIRST, which caused severe tearing. Most women who have 2nd degree or worse tears were directed to push without the actual urge and were on a "timeline" for birthing their child.

And, most women who have NOT episiotomy and a natural birth don't tear at all.  Having your perineum injured isn't a inevibility of birth. It usually happens as a reasult of other medical interventions.


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      HazyAmy
4.20 (Good) | July 2006 | HazyAmy
interesting opinon
It's always good to hear from people of both sides...I wish I could have an "uncontrolled" birth.  I'm very high risk and must deliver in the hospital, but that's a whole different topic.  As for our difference of opinions, we'll just have to agree to diagree!!  I'd love to get to know you better, it's thses kinds of discussion I enjoy having and most of the time it's with my best girl friends!


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           mrslunar
3.83 (Good) | July 2006 | mrslunar
interesting opinon
Its not really a difference of opinion so much as believing science and statistics or not.  It's your opnion it's better to be cut, but it's scientific, medical fact it's better to tear, you know what I mean? It's not my opinion, really.  Still, some people are uncomfortable with letting nature take it's course I definitely understand that. I was a nurse myself for about two years and a doula for two years..........sometimes facts make people really uncomfortable about birth, especially medical professionals! Hopefully over the years, those attitudes will change and women can be more in control of their own health care. It's why I could never work in the medical field again, personally.


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Addcut, episiotomy, stitch, tear

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