Go

As a labor and delivery nurse I really didn’t see that many episiotomies, but I did see plenty of tearing. Most recently with a four pound delivery, which I found really upsetting. The issue from my point of view is providers who rush crowning and the final pushes, combined with the directed pushing that is standard with Obs. When I saw my first delivery with a midwife (Sandy Woods at Roosevelt hospital—amazing!) I was in awe. There was no yelling, no anxiety, and no tearing. The problems with active management of labor (the medical model) are many, and increased vaginal trauma is definitely one of them. Yet another reason to find a great provider. Here’s a question to ask a provider you are considering: “what do you do to prevent tearing?” Unless they have specific answers, like: “allow time during crowning for the perineum to stretch,” “use warm compresses,” “allow mom to push at her own pace,” the likely answer is that this is not something upon which this particular provider places much value.