Exploiting My Baby* *Because It's Exploiting Me

Episiotomy: A Cut Above (the anus)

General StuffTeresa Strasser60 Comments

Lyricist of my vaginal nightmares. Let me throw these two words at you: fecal incontinence. Now that I’m seven months pregnant, I have finally gotten around to taking a break from worrying about what kind of mother I’m going to be in order to get to the urgent business of stone cold panicking about how this kid is getting out of me, and what damage he might do as he leaves. At my last doctor visit, we had the episiotomy talk, and now I can’t stop thinking about the potential slicing of my privates, or the uncontrolled tearing, or the aforementioned fecal freaking incontinence, which happens to some women after childbirth.

According to Rod Stewart, “the first cut is the deepest,” but I think it’s safe to say any cut that might lead to bowel leakage is the deepest, at least emotionally and spiritually.

First and second trimester concerns seem almost quaint in their solvability. Nauseas? Enjoy some ginger chews and pop some B-12. Leg cramps? Stretch your calves before bed and eat a banana. Your baby’s head is too big to exit your vagina? Slice open the area between your anus and vulva, stitch it back up, and hope you don’t end up with the inability to control the seepage of gas and stools from your bowels due to a torn sphincter.

Perhaps I was intentionally fuzzy on the episiotomy thing. I wasn’t ready to know about my perineum. Call it squeamishness, or emotional immaturity, or just ignorance.

That is, until last week, when my doctor told me that he was a big fan or cutting, that most women will tear and if you do a preemptive cut, you can control the severity and direction, keeping the tear away from the bad place. Fecal incontinence and severe, lingering sexual pain averted.

Sounded reasonable to my husband and me, until we got home and consulted a few pregnancy books, most of which suggest that cutting is old school, and that perineum massage during labor can help the vaginal opening stretch, leading to just a small tear or no tear at all. Friends who have had babies are all over the place, some insisting, like my doctor, that cutting saves you from a jagged tear, others saying a rip is more natural and heals more easily.

I’m in labial limbo – okay, not precisely, but alliteration is so seductive.

At times, I feel guilty for making such a big deal out of this cut/tear thing when I’m bringing a person into the world. Why should I care so much about my little old vagina and anus? That’s when I come to my senses. This is a big deal. Fecal incontinence hangs in the balance. I have no idea which is best, and I assume it depends on you, your baby, your labor and I also assume that you probably want a doctor who hopes for a tear but makes a cut if need be.

I haven’t figure out what to do about this yet. I comfort myself with the notion that just as boots are made for walking and kidneys are made for filtering, vaginas are made for stretching. I should be fine. Sometimes, this is obvious, and other times, it ‘taint.