All cuts are not equal

Like many things in life, episiotomies are not all created equal. I've had many a conversation about childbirth after Cooper was born where people act very, very shocked about the fact that I had an episiotomy! At the Birth Center! How can that BEEEEEE?

Dude, the kid was huge for my frame, and I was kinda tired after 4 hours of pushing, OK?

So I feel like venting.

First off, the Birth Center's episiotomy rate is about 1 in 100 births. So you can rest assured that it was medically necessary, and not a routine operation. The US national average is 1 in 3, if that tells you anything.

There are four classes of episiotomy. I had a First or Second, depending on whether you ask my midwife or my doula. Regardless, this means it was conservative incision that involved no significant connective tissues (no muscle tissue was cut).

A First degree episiotomy barely requires stitches at all, while a second degree does but not too many, and the recovery time is minimal. Very little blood is lost in either case. Either way, we are not talking a huge deal. Uncomfortable, sure.

For reference, a Third degree is usually what women have if they have a vaccuum or forceps delivery, or if they are unable to effectively push. A Fourth degree is what people have if there is a serious emergency at the very, very end of vaginal delivery with the baby or mom- it is basically a C section from below. Both of these involve significant loss of blood.

Third and Fourth degree episiotomies are very unpleasant and take a long time to recover from. The stitches often tear, infections are common, and they are associated with bad side effects like everyone's favorite... fecal incontinence. Ugh.

I know one person very well who had a third degree episiotomy. She describes it as being cut in half. She was unable to walk for two days, and it took months for her to feel at all normal. She still has some side effects. So I know that it is no fun.

But please, when you hear about episiotomies, remember; they are not all the same. Some are very minor, others are very serious. You can't assume either way.