Shopping Cart
Your Cart is Empty
Quantity:
Subtotal
Taxes
Shipping
Total
There was an error with PayPalClick here to try again
CelebrateThank you for your business!You should be receiving an order confirmation from Paypal shortly.Exit Shopping Cart

Sweet Pea Births

Chandler, Arizona

Sweet Pea Births

...celebrating every swee​t pea their birth

Blog

Information Sheets

Posted on June 18, 2013 at 9:11 AM Comments comments (0)
As an instructor, I am often asked, "What would you do?"  As much as I would love to help  out by offering an anecdote or an opinion, I cannot do that.  The choice I would make might not be the right one for your family.  So instead, I find myself compiling links to additional reading and sending them off.  Cassandra often finds herself in the same situation.  We keep going back and recreating this information as it is requested, which can be time-consuming.  As our children's demands change, the project may get delayed, and we don't like to keep people waiting! 

My solution is to start a library of Information Sheets about procedures and options that are offered in pregnancy, labor and to your baby as part of their postpartum newborn care.  She and I have compiled a list of topics that we want to present and we will each be researching and posting one per month.  Instead of having to go back and find all the links we like on a particular topic, we will be directing people to the Information Sheet on the blog.

My goal is to present the information in an un-biased way as possible.  So here is our approach:

*Definition of the procedure/test

*History: Why was it developed?  What was it supposed to treat?  Has it been effective: as in, has the incidence decreased or has a problem been solved as a result of the intervention/procedure/test?

*Links to pros and cons from sources that we know are reliable, not purely opinion or anecdotes.

*Links with other options to explore if they want to decline the test/procedure/intervention from reliable sources

We hope you will find these helpful.  If there are any topics that you are wondering about and have at the top of your list, please leave a comment and we will address those first.

In the spirit of providing a basic understanding along with information for you to do your own research and draw your own conclusions, here are our Information Sheets.  The list of links will grow over time - keep checking back for more links, or click on the Info Sheet topic link on the left column for additional topics as they are added.

Pregnancy
Caffeine & Alcohol - added 09/05/14
Group B Strep Test - added 7/26/2013
Perineal Massage - added 2/7/14

Labor
Amniotomy (AROM) - added 2/06/15
Epsiotomy - added 06/19/2013
Forceps & Vacuum - added 11/19/13
Gowning - added 01/31/14
NPO: Non Per Os - added 09/24/2013
Stripping Membranes - added 04/18/14
Water Birth - added 01/02/15


Newborn
Cord Clamping - added 07/05/2013
Diaper Wipes - added 05/30/14
Eye Ointment - added 07/23/2013
Hepatitis B Vaccine - added 01/24/14
Male Circumcision - added 11/26/13
Vitamin K Shot - added 10/04/2013


Disclaimer:
Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonThe material included on this site is for informational purposes only.  It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.
This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.


Info Sheet: Episiotomy

Posted on June 18, 2013 at 8:40 AM Comments comments (28)
Episiotomy:  A surgical cut made at the opening of the vagina during childbirth

Anatomy of the perineum
Anatomy of the perineum
From WikiCommons
Types of Episiotomy
Types of Episiotomy
From WikiCommons
Definitions from WikiParents:
1st Degree – This is a small incision that goes through just the skin of the perineum
2nd Degree – This is the most common degree of episiotomy, it cuts through both the skin of the perineum as well as the underlying tissue
3rd Degree – Cuts through the skin of the perineum as well as the underlying tissue and the muscle that surrounds the anus
4th Degree – Through the skin of the perineum as well as the underlying tissue and the muscle that surrounds the anus and into the lining of the rectum
Midline - the incision is made starting at the vaginal opening, and continues in a straight line towards the anus
Medio-lateral - begins at the vaginal opening and angles off towards the buttocks at a 45 degree angle.


Why was it developed?  What was it supposed to treat?
Mayo Clinic: “An episiotomy was thought to help prevent more extensive vaginal tears during childbirth — and heal better than a natural tear. The procedure was also thought to keep the bladder from drooping and the rectum from protruding into the vagina after childbirth.”
Medicine.Net: “It can also decrease trauma to the vaginal tissues...Doctors who favor episiotomies argue that a surgical incision is easier to repair than a spontaneous irregular or extensive tear, and is likely to lead to a more favorable outcome with fewer complications.”

Has it been effective?
Mayo Clinic: “Research suggests that routine episiotomies don't prevent these problems after all.”
2005 study conclusion: "Routine episiotomy achieves no short‐term goals that it has been hypothesized to achieve. Indeed, routine use is harmful to the degree that it creates a surgical incision of greater extent than many women might have experienced had episiotomy not been performed."

History:
From social to surgical: historical perspectives on perineal care during labour and birth
“A review of key historical texts that mentioned perineal care was undertaken from the time of Soranus (98-138 A.D.) to modern times as part of a PhD into perineal care. Historically, perineal protection and comfort were key priorities for midwives, most of whom traditionally practised under a social model of care. With the advent of the Man-Midwife in the seventeenth and eighteenth century, the perineum became pathologised and eventually a site for routine surgical intervention--most notably seen in the widespread use of episiotomy. There were several key factors that led to the development of a surgical rather than a social model in perineal care. These factors included a move from upright to supine birth positions, the preparation of the perineum as a surgical site through perineal shaving and elaborate aseptic procedures; and the distancing of the woman from her support people, and most notably from her own perineum. In the last 30 years, in much of the developed world, there has been a re-emergence of care aimed at preserving and protecting the perineum. A dichotomy now exists with a dominant surgical model competing with the re-emerging social model of perineal care. Historical perspectives on perineal care can help us gain useful insights into past practices that could be beneficial for childbearing women today. These perspectives also inform future practice and research into perineal care, whilst making us cautious about political influences that could lead to harmful trends in clinical practice.”
Copyright © 2010 Australian College of Midwives.

Pros - When an episiotomy might be medically necessary:
  • Baby is in an abnormal position and might need manipulation or forceps to aid in vaginal delivery
  • Baby needs to be delivered quickly due to fetal distress
  • Extensive vaginal tearing appears likely: easier to repair a single cut than multiple jagged edges

Cons of episiotomy:
  • Higher incidence of a third or fourth degree tear that extends into the external anal sphincter and the rectum
  • More blood loss
  • More pain and discomfort in the postpartum period
  • Painful intercourse
  • Incontinence
  • Additional surgeries to repair or reduce discomfort from initial episiotomy

Links to continue your research and draw your own conclusion about what is best for your family:
2005 Hartmann et al Study The Use of Episiotomy in Obstetrical Care: A Systematic Review: Summary
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0010365/

Has the incidence of episiotomy decreased since the 2005 study:

From The Mayo Clinic:
Epsiotomy: When It’s Needed, When It’s Not

From Childbirth Connection
Preventing Pelvic Floor Dysfunction: Episiotomy

From Childbirth Connection
Preventing Pelvic Floor Dysfunction: Tips & Tools to avoid episiotomy

Science & Sensibility
What Is the Evidence for Perineal Massage During Pregnancy to Prevent Tearing?

Science & Sensibility
Tribute to Dr. Michael Klein with video about history of episiotomy and information about his studies

Summary of Dr. Klein’s Study

Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonDisclaimer:  
The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.


0