The incision of the perineum during childbirth (episiotomy)

In some cases, the need arises during delivery perineal incision. This small surgical procedure is required for the low elasticity of the cervix in order to avoid gaps, with the threat of the fetus to speed up delivery, and others.

There are different opinions about the necessity of this operation and the pros and cons better to discuss in advance with your doctor.

The advantages of episiotomy include:

  • expansion of the birth canal;
  • a straight incision is sutured easily than large gaps;
  • accelerated delivery for 15-30 minutes, which is especially important during long labor when the forces are exhausted mothers;
  • made an incision just protects against damage to the muscles of the perineum and vagina;
  • if appropriate overlay forceps or vacuum extractor creates additional space;
  • the birth of a premature baby decreases the pressure on the baby's head.

Episiotomy Opponents believe that the birth should take place in a natural way, and noted some of the negative points:

  • discomfort in the early postpartum period;
  • performing the procedure unnecessarily;
  • the danger of infection at the incision site;
  • possible pain during intercourse for several months after birth.

Done basically two types of episiotomies: central (at an average muscle) and mediolateral (center-side). Central incision is made directly to the backside in the direction of the anus. Despite its advantages (with respect to the length of the incision is larger expansion exit the birth canal, well healed, it is easier to sew, it causes less bleeding, lower incidence of postpartum ailments and no contamination), it is rarely used because of the high risk of rupture of the perineum to the rear passage. To avoid this risk, most doctors, especially at first birth, choosing srednebokovoy incision that passes the anus.

Paradoxically, but in practice the protective incision heals better protection gap. And one more thing "for". Muscles and if not broken, then subjected to stretching so strong that further reduces their tone and can cause uterine prolapse.

You can discuss with your doctor the pros and cons, but keep in mind that the final decision will be made in the delivery room with a view of your condition in the first place with the possibility of a safe birth.

 The incision of the perineum during childbirth (episiotomy)

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Premature births are considered to be occurred as the interval from 28 to 39 weeks of pregnancy. Born fetus is viable, but the 28-week baby can not even live on their own - primarily due to the underdevelopment of the lungs. But to leave him if he was born in this period, it is easier than in the previous month. This requires special equipment and the efforts of neonatologists. After all, growing and developing baby relies additional 12 weeks.

According to statistics, the majority of children are born rather later than early. The number of premature births, according to various estimates, from 2 to 7%, one-third of preterm births caused by the early onset of labor, one-third - premature rupture of membranes of the fetus, and the rest due to complications of the uterus or the fetus. Less than 3 out of 4 preterm births occur in women, pregnancy which are categorized as high risk.

There are many factors that increase the risk of premature birth. The more there are risk factors in the patient's history, the greater the likelihood of premature termination of pregnancy. Below are the main risk factors, which often can be eliminated, and thus increase the chance of successful completion of pregnancy.

Major risk factors


Stop smoking before pregnancy or at the very beginning.

Alcohol consumption

Avoid regular consumption of beer, wine and stronger alcoholic drinks (since no one can define what "too much", it is better not to drink).

Abuse of drugs or narcotics

Do not take any medication without the consent of a doctor who knows that you are in position, do not use any drugs.

Inadequate weight gain

If your pre-pregnancy weight was in the normal range, to term it should grow by 12 kg.

Inadequate nutrition

Follow a balanced diet, make sure your diet includes zinc (some research has linked a shortage of zinc with an increased risk of preterm birth).

Heavy physical work, or work in a standing position

If your professional work and household chores require daily standing for a few hours, stop or limit them.

Sexual relations

Expectant mothers who have preterm labor should abstain from sexual intercourse and / or orgasm during the last two or three months of pregnancy (orgasm in the women may cause active contraction of the uterus).

The absence of hormonal balance

This can cause so later generations, and a premature. Substitutsialnoe use of hormones can prevent this.

It is not always possible to eliminate all risk factors, but the results may be modified


For example, rubella, certain sexually transmitted diseases, inflammation of the urinary and reproductive tracts. If there was infection, which represents a threat to the fetus, the premature birth of the child will fall from a dangerous environment. In case of uterine infection, which may be a cause of premature birth, immunological response simulates the production of prostaglandin, which can initiate labor, as well as substances that can damage the membranes of the fetus and lead to their premature rupture.

To reduce the risk of infection, stay away from sick people, more Exercise and rest are optimally nourished and regularly see a doctor. Some doctors recommend the use of a condom during the last three months of pregnancy to reduce the risk of intrauterine infection.

Functional insufficiency of cervical pressure

This is a condition where the neck opens prematurely. Often it is hard to see until you come late or premature birth. Seeing it on time, you can avoid premature birth, putting circumferential joints in the neck about 14 weeks of pregnancy. Some women, for reasons completely unknown and unrelated to the disadvantage of the pressure neck, cervix begins to open relatively early. In connection with this very useful to experienced survey.

Sensitivity of the uterus

Studies show that some women, the uterus is particularly sensitive, and this tendency can activate premature uterine contractions. Some believe that the detection and monitoring of such women in the third trimester can help in the prevention of preterm birth. It is recommended that the use of drugs and stay in bed all day or intermittently to moderate uterine contractions.

Placenta previa

Children place is situated low, near or over the internal opening of the cervix. This condition can be detected during ultrasonography. Sometimes we do not even know it until the appearance of bleeding in the second or third trimester of pregnancy. Compliance with the exact bed rest may prevent preterm birth.


Sometimes it is possible to eliminate the causes of stress or minimize it (interrupting the work, which it is, or get advice in the event of marital troubles). Sometimes it is difficult to eliminate the cause, for example, if you lost your job or if you are alone in expecting the birth of a child. But every kind of stress can be reduced through appropriate training, the use of relaxation techniques, adequate food, or balance of activity and rest periods, as well as a resolution to this problem, perhaps with the assistance of family or friends.

Chronic disease mother

For example, hypertension, liver disease or kidney disease, diabetes. Appropriate medical care, often in conjunction with absolute bed rest, can be a good prevention for preventing preterm birth.

Age 17 years

Optimal nutrition and adequate medical ward to help compensate for the fact that both the mother and her child, still continue to grow.

Age over 35 years

The risk can be reduced through adequate nutrition, adequate medical care, except for stressful situations, as well as studies related to genetic disorders and obstetric problems.

Incorrect structure of the uterus

If a diagnosis was made, the appropriate surgery before pregnancy to rectify the irregularity, often prevents premature births.


Women who have celebrated multiple pregnancy, on average, give birth three weeks earlier. Careful guardianship, proper diet, bed rest, restriction of activity as far as necessary in the last trimester of pregnancy - all of which can prevent premature labor.

Problems with fruit

In some cases, the diagnosis time and allows you to discover the shortcomings cure them even in the womb. Sometimes, this correction allows childbirth to occur in time.

However, sometimes it happens that there is not any one of these risk factors, and women's health with proper pregnancies suddenly begins to give birth prematurely, without any reason. Maybe someday be able to determine the cause of preterm labor, but they are now covered by a single concept: "the cause is unknown."

Studies show that even if there are risk factors, it is possible to reduce the number of premature births through prenatal education, as well as monitoring the contractions of the uterus.

Often starting preterm birth may be inhibited until the time until the child reaches greater maturity. It may be useful, even a short-term extension of the period of pregnancy. Each additional day that a child spends in the uterus increases the chance of a lifetime. Therefore, it is important to know the events preceding the premature birth, and the ability to recognize them, to tell the doctor:

  • cramp-like periods, with or without diarrhea, nausea or indigestion;
  • pain and pressure in the lower back, or change the nature of the ailment in the body;
  • pain or squeezing feeling in the pelvis, extending to the lumbar region and hips;
  • the changing nature of discharge, especially if they are watery or tinted pink-red or brown, the appearance of a thick mucus plug may, but shall not precede them;
  • fetal membranes rupture, leakage of amniotic fluid from the vagina.

All of the signs are in the normal course of pregnancy and is sometimes very difficult to suspect the approach of premature birth, even an experienced doctor can not directly with an accuracy of a diagnosis, it is necessary to conduct a survey, you need some time for observation.

If you suspect a miscarriage a woman should be hospitalized.
If you still, despite all efforts, premature birth began chance to return home with a healthy baby are great (of course, is to return home may be delayed).


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