Posted in childbirth, Musings, Rants, tagged Episiotomy on December 27, 2012|
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One of my favourite comedians is Dara O’Briain. I love his forthright take on issues and his ability to spin off on a fantasy tangent, so imagine my joy when I was watching recently and he began talking about antenatal classes, both NCT and NHS. My ears perked up in rediness for some insightful side-swipes at the presentations he had sat through. It started well, the tone of voice we (some of us) use and the way midwives voice their opinions about doctors being over involved (true). It was during this second observation that my ears pricked up and I started shouting at the TV, something that only usually happens during One Born Every Minute. Mr O’Briain began talking about how the facilitator of the class exhorted the attendees not to let ‘the doctor near them with a knife’, it may have been scissors, or it may have been to cut them, but basically ‘Don’t let a doctor do an episiotomy’. The person went on to say that it was better to tear rather than to be cut, and it was this aspect which Dara went on to disect, using the fact that his wife is a surgeon to support his jocular comments which were ridiculing this attitude.
Tears versus cuts. Research has shown that the use of episiotomy should be restricted, for various reasons, but the one I shall highlight here is healing. As the person presenting Mr and Mrs O’Briain’s classes said, ‘a tear generally heals better than a cut’, this is especially true with muscle. During a caesarean section the surgeons tear the muscle. Why do they perpetrate this violence? If you tear a muscle it generally separates in the direction of the fibres, the fibres can then knit together better following surgery. Move from the abdomen to the perineum and the same logic must apply, with an episiotomy you just cut in a straight line, with a tear it is more likely to follow the fibres, therefore the chances are that it will heal quicker and with less pain. My final thought on this is that an episiotomy ‘may produce a larger wound to heal than would have been produced without intervention‘.
Less pain, better healing and a smaller wound? I know which option I would choose.
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Posted in Family, Musings on December 16, 2012|
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Nearly every night I think ‘I must blog’, and every night I get carried away with something else. Tonight I shall put fingers to keyboard though, after all I started blogging to maintain an on-line diary, to recount my journey into Grandparenthood. I was amazed when I started receiving comments, I was amazed but I was also gratified. I used to blog freely about my family, but I drew my horns in when a reader took huge issue about a piece I had written and told me that she had discovered who I was and that she was going to notify my employers, and the NMC about my Blog. I was horrified. I was fairly sure that the NMC would not have complaint with me, after all I didn’t break confidentiality or bring the profession into disrepute however, once my anonymity was compromised then confidentiality issues may have arisen. My employers, they may not have been too happy about my ‘musings’ as they sometimes referred to employment topics and local employment topics at that. I could have been in serious trouble. I closed down my blog for a couple of months, deleted the writing she found offensive and held my breath. Months later, when I had heard nothing, I started writing again. Momentum was suffered though and I had lost the ‘discipline’ of regular blogging. I am going to make a New Years resolution, blog at least once a week.
I’m still a midwife. Recently I received a ‘promotion’, really it is just an official recognition of a role I have been helping with for over a year, but it does give me a new job title. Over the last 18 months I have also assumed two other roles within the maternity services, one clinical and very few hours, the other non-clinical but together they take me up to full-time hours, and more. I am approaching retirement age but, due to my husbands pension having become negligible since G Brown did something, don’t know what but it made Hubby’s pension pot leak a huge amount, and my state pension age running away from me at breakneck speed, I can see that I shall have to put in the elbow grease for a few years yet. Midwives and childbirth have been much in the news over the past few months and, with Will and Kate announcing her pregnancy, I expect procreation will remain in the spotlight.
My family are all well. 16 of us now and all spending Christmas Day together. Hectic week ahead but culminating in a fabulous, chaotic, noisy but joyous celebration and, of course, Ruby’s first Christmas
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