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Mon, 29 Nov 2004 09:33:10 EST |
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Nikki notes:
<<As for healing, a natural tear heals more quickly than a cut; a cut has
been identified as a cause for greater tearing. While it is possible to
have
a 3rd or 4th degree tear spontaneously, the chances are much greater to have
a terrible tear like this if the perineum has been cut. It's the same
process
as nicking the edge of some material to make tearing easier.>>
************************************************
Right on, Nikki!!
I don't have the statistics in front of me, but when I was the director
(head nurse, if you will) of the out of hospital Family Birthing Center in
Southfield Michigan from 1979 to 1982 when I left to move to Chicago, we certainly
kept track of the above. Back then, episiotomies were absolutely the norm,
though our physicians were trying to avoid them. I think, if I remember
rightly, we had about a 60% episiotomy rate. I can say that the ONLY 4th degree
tears into the rectum (or 3rd degree, for that matter) were when an episiotomy
had been done first. There was NEVER a "spontaneous" 4th degree. Now, I'm
only talking about the first 3 years of the birthing center's existence. I
won't speak to the next 20 years, because I don't know what happened and don't
have the stats for those years.
I also know that the moms I currently see in the hospital that end up with
an episiotomy have far more discomfort than the moms with a laceration. They
also have a much harder time w/ comfortable positioning -- it's incredibly
difficult to concentrate on breastfeeding when your bottom hurts so much that
you can't stand it.
Jan Barger, RN, MA, IBCLC
Wheaton IL
www.lactationeducationconsultants.com
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