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Episiotomy: Avoiding the Unkind Cut

Susan Spears figured she was on her way to a smooth delivery -- after seven hours of active labor, this first-time mom felt ready to push her baby out. But just 20 minutes later, and against her expressed wishes, her doctor decided to move things along by performing an episiotomy, an incision in the perineum -- the space between the vagina and rectum. In an instant, a healthy 7-pound, 11-ounce girl was born.

Spears was thrilled to have her daughter in her arms, but her recovery, thanks to the episiotomy, was less than thrilling. Within a day of delivery, the stitches her doctor had put in to sew up the cut dried out (she hadn't been instructed on how to care for them, such as taking frequent sitz baths -- soaking in a shallow bath of water -- to keep them moist). They pulled painfully, and some even ripped out. "It hurt whenever I moved or even laughed," she says. Even after the site had ostensibly healed, Spears "felt" the incision -- and grew skeptical about the necessity for the procedure. "I believe my doctor did an episiotomy because she was trying to hurry along the birth process," she says.

Fast-forward seven years. Pregnant with a second daughter, Spears switched to a practitioner who assured her she'd do everything possible to avoid an episiotomy. During labor, "she massaged my perineum," says Spears. "I popped out a 9-pound baby after about 20 minutes of pushing without so much as a tear." The lesson? It pays to question some birthing practices. Just because episiotomy was once routine doesn't mean it still should be. Lots of moms are left to wonder if their episiotomies were necessary. Some experts are also asking questions.