Ok, Everything looks great. No tampons or sex for 6 weeks.


I never want to put anything in that thing again!

The thought of it was terrifying. Sex after a vaginal birth…. are you kidding me?

I was sore. I mean really sore. 21 years ago, I had an episiotomy during the birth of Erica. An episiotomy. You know, where the doctor sticks half of an open scissor inside your vagina and crunches it shut, leaving a gaping incision at the bottom of your vagina. After the baby is born, he sews it up, makes some sick little joke about its size and pronounces you… good as new.

Good as new?!?!?! I felt like shit. Oh, and I forgot to mention, my husband watched in horror as that little procedure took place.

I could barely walk and the idea of sitting was a joke. I was a one-cheek sitter for the first 10 days. The only thing that brought the slightest bit of comfort was that peri bottle (you know, the squirty water bottle they give you to dilute your urine when you pee). Otherwise, I was in utter pain. I was taking care of myself, my newborn and my nipples, all while trying to recover from the scissor incident.

If I only knew then, what I know now….

Thank goodness (in most cases) episiotomy is no longer routine. In the last handful of years, as a doula attending a lot of births, I have seen two. Two necessary episiotomies. Two necessary episiotomies with the consent of the woman who owned the vagina.

In all other cases, with support at the perineum, the opening of the vagina stretched to allow the baby to emerge.

So, how can we support and prepare the perineum you ask?

The perineum is made up of muscles and muscles have memory. Leading to your estimated due date, start enjoying a warm compress against your vagina before sexual intercourse. It is relaxing and encourages the muscles in the perineum to relax. In the later stages of labor, have your doula or partner prepare a warm compress and put it on your birth ball (physio ball, exercise ball etc. they are all the same) Sit on the warm compress prior to pushing to remind those muscles to relax. If you don’t have a ball with you or you have chosen a facility to give birth in that won’t allow you to get out of bed, have someone hold the warm compress against you instead. Sitting in a warm tub of water has the same effect.

Discuss options with your provider prior to your birth regarding their comfort level with your choices.

Some questions to consider discussing with your doctor or midwife in regard to this topic:

~Do you do routine episiotomy?

~Can I use the tub (if there is one available to you) during my labor and birth if I choose?

~Will you do perineal massage during my delivery?

~How will you support my perineum during my delivery?

~Will you use medication to numb me if a repair becomes necessary?

~What do you recommend for pain and healing of the perineum?

Authored By: Randy Patterson