Get Through Childbirth In One Piece!

By Elizabeth Bruce

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Every baby’s birth is sacred. Parents and babies intuitively know this, even when beeping machines, multiple spectators, bright lights and other distractions surround them. If left to our own instincts, we human mothers would probably behave much like mother cats, seeking out private, dimly-lit places to give birth. Since about the 1950s, however, the majority of U.S. births have taken place in hospitals. Most Westernized doctors believe that women “need” an episiotomy to give birth.

Certain popular “experts” effectively encourage episiotomy by saying that “stretching may leave the muscles a little slacker than will a carefully timed episiotomy; one in which the perineum wasn’t allowed to stretch excessively before the incision was made.” Nonsense! It sounds credible, but there is not a scrap of research to back this statement up [believe me, I’ve looked]. The statistics on interventions are gloomy. A woman giving birth vaginally today has at least an 80% chance of receiving an episiotomy. A research review by the World Health Organization, however, indicates that evidence only supports a 5 to 20 percent episiotomy rate. Recent medical journals agree. An article in Obstetrics and Gynecology concluded, “Routine episiotomy is no longer advisable.”

Episiotomy — the cutting of perineal tissues during delivery – is, in my humble opinion, an outdated carryover from the 1700s. The perineum is the delicate area between the vagina and the anus. If you have ever torn or suffered an episiotomy during childbirth, you already know this area intimately (as in ‘Ouch! Give me that inflatable donut!’). To make things worse, women are not routinely anesthetised before an episiotomy. This inhumane treatment is based on the theory is that “she won’t feel a thing” due to the baby’s head on the perineum. Not true! While there is a natural numbing effect, the perineum is still sensitive to pain during this time.

Although episiotomy has been billed as a simple operation, it carries the risk of complications, including excessive blood loss, hematoma formation (a form of swelling or bruising), infection, and abscessing. Sometimes trauma from an episiotomy leads to a loss of rectal tone and, in severe cases, a fistula, or hole between the vagina and rectum. In spite of smug assurances that “the site of an episiotomy or laceration will take time to heal – usually seven to ten days,” oftentimes healing takes much longer — up to two years in some cases. Even with a small episiotomy, sexual functioning can be affected. At times, stitching done to repair an episiotomy does as much damage as the original incision.

Unfortunately, the pain caused by episiotomy can make it harder for new mothers to breastfeed and bond with their infants.

The good news is that there are many things you can do to get through childbirth intact. My suggestions for avoiding episiotomies, based on experience and careful research

Elizabeth Bruce, mother of four, is the author of Get Through Childbirth in One Piece!: How to Prevent Episiotomies and Tearing , available through and She is a CCE with Birth Works, and can be contacted directly at Her web address is