Understanding Episiotomy: What Expecting Mothers Should Know
Episiotomy, commonly referred to as a perineal incision, is a surgical procedure performed during vaginal delivery to facilitate childbirth. According to Dr. Yang Jie, the Deputy Chief of Obstetrics at Guangzhou Medical University Third Affiliated Hospital, some portrayals of this procedure are overly dramatic. The necessity for an episiotomy largely hinges on the conditions surrounding both the mother and the fetus.
Reasons for Performing an Episiotomy
In contemporary settings, many mothers require an episiotomy due to practical considerations. A lack of physical activity among modern mothers can lead to inadequate force and vaginal muscle contractions during labor, making it more challenging for the baby to be born. Furthermore, pregnancy-associated nutritional excess may result in oversized babies, while a rise in older expectant mothers adds another layer of complexity to childbirth. These factors contribute to an increased prevalence of episiotomies, but it is crucial to note that it should not be seen merely as mothers being "cut."
Lack of Exercise and the Consequences
Dr. Yang emphasizes that for a baby to be born, it must traverse the uterus and exit through the vagina. Although the vagina can stretch, if the baby is too large—with a head and body diameter reaching 10 centimeters—there is a significant risk of tearing. This tearing can lead to severe complications, including pelvic organ prolapse and urinary incontinence. Consequently, midwives may perform an episiotomy to prevent more extensive tearing, which would not only complicate healing but also create noticeable scarring.
Identifying the Need for an Episiotomy
In some cases, if the baby's position is unfavorable, medical professionals may need to manipulate the baby's head for a smoother delivery. This adjustment may necessitate an episiotomy as well. Dr. Yang mentions that if labor does not conclude within two hours after full dilation, the risks increase. Prolonged pressure in the birth canal can damage the pelvic floor muscles, heightening the likelihood of future issues like vaginal laxity and urinary incontinence, and may also pose risks to the baby's well-being, such as hypoxia or cerebral hemorrhage.
The Importance of Prenatal Checks
Dr. Yang stresses the critical role of prenatal examinations. Some mothers tend to overlook gynecological checkups before childbirth, which can lead to infections in the genital area. Such conditions increase the likelihood of vaginal tearing during delivery and complicate the healing process. Thus, mothers with gynecological infections may be more likely to require an episiotomy.
Conclusion
Ultimately, the decision to perform an episiotomy is a medical one based on the unique circumstances of each pregnancy and delivery. By understanding the factors that contribute to this procedure, expectant mothers can better prepare for childbirth and recognize the importance of comprehensive prenatal care.