# Episiotomy, Back to back delivery and Waters breaking



## daycj (May 11, 2004)

Sorry this is such a mammoth topic but I spent ALL DAY on Saturday at an NCT class which was specifically on labour.  The lady who took the class did advise at the beginning that she would be "brutally" honest but I think there's honest and downright stupid and I'm not certain she didn't overstep the mark on that score.  She is obviously not that impressed with my local hopsital (neither am I actually for different reasons) but she has scared the pants off me and I was hoping this NCT class would reassure and not make me even more nervous than I am.  

I would know like to get the "other side of the story" from a midwife..............

Apparently at my hospital it is "policy" to break all waters.  Reason given: speeds up labour.  NCT lady said - utter rubbish - has no effect and if I don't want waters broken - put it on birth plan.  She could see no benefit to having waters broken.  

Back to back delivery.  She told us that if you're baby is lying back to back then it has to turn 180 degrees as opposed to 90 degrees with a "regular" cephanlic birth.  So........the good news we were given was that labour would be a minimum of 36/48 hours.  I'm not convinced on this as my SIL had my nephew back to back and she said it was 15 hours from start to finish (ie. first labour pains).  

Finally episiotomy.  She seemed to be pro-tearing as she said the tear would go with the grain of the muscle and if cut it goes against the muscle so healing is longer.  Advice please?  

Sorry to sound like a complete fruit but I've been working myself up into a steam about the whole birth thing anyway and this just about iced my cake!  

Thanks.


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## emilycaitlin (Mar 7, 2006)

Hi,

Sorry for the delay in replying, but I just spent 15 minutes writing a reply and my internet connection cut out!!!!

It certainly sounds like you had a big shock on Saturday!!

Waters breaking – I have never come across a hospital that has a policy of routinely breaking your waters.  It is often done in labour if labour is progressing very slowly, as it can speed things up by allowing baby’s head to come down more onto your cervix, if they are concerned that your baby is in distress, it can be a way of confirming it to see the colour of the amniotic fluid, to see if your baby has opened its bowels inside you.  There are various other reasons that it may be necessary to break your waters, but if you are in normal labour, with things progressing well, and no other problems, there shouldn’t be any reason for breaking them.  Some babies are born in the sack of waters!  It is YOUR labour, and you have a large amount of control over it.  No-one can do anything to you without your consent, and don’t be afraid to say no, or to ask for more information.

Back to back – Some babies trun from this position in labour, and some don’t.  Either way, babies can still be born.  This position can make labour a little bit slower, and give discomfort in your back. However, you will not be allowed to be in ACTIVE labour for 36/48 hours.  It will be against hospital policy, who will have a set guidance rate that labour should progress by.  By active labour, I mean regular strong contractions, that are dilating your cervix by 3cm and continuing.  Often, prior to labour you can have strong practice tightenings, which can feel a bit like the onset of labour,but don’t actually have a big effect on your cervix.

Episiotomy – The most recent research that I know of  suggests that tearing is better than episiotomies.  A tear may be much smaller than an episiotomy would have been, and tears do tend to heal quicker.  It may be necessary to perform an episiotomy, for example, if your baby is getting distressed, and needs delivering quickly.

I’m sorry that you have had such a worrying couple of days.  At your next antenatal appointment, ask your midwife what the hospital policies are, as they differ everywhere.

Please try and look forward to the experience, as, scary as it seems, should be an experience to remember, for all the RIGHT reasons!

Good Luck,

Emilycaitlin xx


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## daycj (May 11, 2004)

Thank you so much for that reassurance.  At my "normal" NCT class last night our regular teacher asked us for some feedback.  Seems I wasn't the only person who was petrified of what she had told us and thought she was too full on.  Our regular teacher who is much calmer did her best to reassure 7 terrified first time mums.  Appreciate all your help as usual.


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