The J episiotomy, Just a Change of Course or a Change of Mind?

Most women who have had a delivery know the word episiotomy, we never had to learn it for scrabble, pretty much too many letters, but we had to learn it for birthing. It's the cut between the vagina and rectum that makes more room for the baby. And most know that the cut can be made straight towards the rectum, essentially at the "6:00 o'clock" position, and it's a risk for a major rectal tear, but on the other hand can make a lot of room. The other option is to go towards the edge or your leg, and sort of towards the butt, and not straight down in sort of a "8:00 o'clock" slant. It's even a bigger cut, but it does tend to avoid cutting into the rectum. It's more likely to heal a bit worse (in many studies, not all) so we tend to cut down. But then there are those that do the J. They cut down and then do a bit of a right turn to avoid the rectum. Sort of looks like a change of course. But then again, perhaps it's a just in time miss the rectum sort of cut. The skill of your episiotomies was really honed in the 70s and 80s if you were catching babies; about 80 % of women had them (then again, we didn't have 330% of first time mom's having C-sections!). You may want to ask your accoucheur (yes, used to mean male, but now, pretty much who you've hired to catch the babe) what is their rate of episiotomy, there's a lot of variation today both around our country and around the world in the rates of any of these operations, straight or crooked.


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