Lateral incision refers to making a 4-5 cm long incision outside the vagina, which usually grows up about 5 days after operation. Intradermal suture is generally chosen for lateral incision, that is, the elastic fibers in the vagina will return to the prenatal state without suture, so that there will be no foreign body sensation in the future husband and wife life. Generally, the perineum of primipara is tight, and the extensibility of vaginal opening is poor. When the baby is born, it may produce great resistance, prolong the labor process, easily lead to the baby's lack of oxygen, and the fetal head is relatively large, while the mother's pelvis is relatively narrow, so it is necessary to use an aspirator or forceps for midwifery. At this point, a lateral perineal incision is needed. If the fetus is blocked in the birth canal and vaginal orifice for a long time, it will cause pelvic floor injury, and the parturient is prone to vaginal wall swelling or urinary incontinence after delivery.
The purpose of lateral incision is to relax the vaginal opening properly and accelerate the delivery of the fetus, which is a kind of protection for both the mother and the fetus. Timely lateral incision can also prevent severe perineal tear and massive bleeding, and greatly reduce the damage to pelvis and vagina during childbirth.
"Ten natural births and nine side cuts", Mo Ma herself was the one who was side cut. Lateral incision is a kind of perineum incision (the other is median incision), which is a common midwifery method in obstetrics. Most natural mothers will encounter it, but some mothers don't need side cutting.
Mother Mo gave birth to three babies. The first one was cut sideways, the second one was torn, and the third one was slightly torn, even without sewing. Mother Mo thinks that her mother needs a knife when she gives birth naturally, for the following reasons.
1. Mother's perineum has poor elasticity.
Poor elasticity of mother's perineum is also a main reason. At the end of pregnancy, the mother's perineum will become swollen and soft, and the YD mouth can be better expanded during delivery to let the fetus pass. However, the primipara's mother's perineum has poor elasticity and expansion, and the fetus can't pass smoothly, which will prolong the second stage of labor and embarrass the fetus. Therefore, the mothers of primiparas often use lateral incision.
2. Perineal laceration is inevitable.
Under normal circumstances, the delivery port is very, very small, and the baby is just like a watermelon. You can't expect a 6-8 kg baby to come out of YD without feeling anything. Many mothers will have lacerations even if they don't cut sideways, and tensile injuries will occur without lacerations.
During childbirth, the doctor will always observe the mother's birth canal. If the parturient's perineum is too long, too short or poorly stretched, serious laceration may occur, and the doctor will even take perineal incision to protect the parturient's perineum and prevent perineal tear.
3. The labor process is too long and the fetus is too big.
The first stage of labor is a very painful stage when the uterus is opened. At this stage, mothers will consume a lot of physical strength. When the second stage of labor requires exertion, the second stage of labor will be prolonged if the parturient is not physically strong enough or cannot exert force correctly; The size of the fetus also has a certain influence on the difficulty of delivery. If the fetus is too big, delivery will be much more difficult. In order to shorten the second stage of labor and relieve the pain of the parturient, doctors will also consider using perineum incision to assist delivery.
The purpose of episiotomy is to enlarge the birth canal, shorten the second stage of labor and avoid severe YD laceration of perineum. As far as Momo's personal experience is concerned, lateral incision is much better than tearing, because lateral incision is local anesthesia, so there is no pain, and the wound of lateral incision is neat and much better than tearing and stitching.
Transverse incision also has some bad effects. For example, if the mother does not use force properly, or if the fetus is too large, it is likely to extend and tear along the lateral incision.
Simply put, lateral incision is not something that all pregnant mothers will encounter. Whether it is necessary depends on the perineum of the parturient and the size of the fetus.
Text 1 Moma parenting classics
Figure 1 is from the source network.
A few days ago, my hometown friend's daughter gave birth to a baby. The child is not very heavy, why do you want to cut it sideways?
There are three main reasons:
First, the perineal body is underdeveloped and tight, and it is easy to tear during childbirth;
Second, the child's head is too big, leaving the vaginal opening is easy to tear the vaginal opening;
Third, the process of delivery is too fast, and the entire perineum has not had time to expand, and it will even be born soon.
Considering these three reasons, and in order to prevent the uncontrollable laceration of perineal body, including fecal incontinence after anal sphincter laceration, in order to prevent these situations, a lateral incision can be made. After incision, the wound should be cleaned after delivery, and then sutured layer by layer. The main steps of perineal suture are to suture the muscle layer of the deep perineum, then the subcutaneous fat layer, and then the epidermis.
This lateral incision is located at the vaginal opening, so one part is located at the vaginal wall and the other part is located at the vulva. The partial suture of vaginal wall is intermittent absorbable suture or silk suture, which needs to be removed. The suture of this part of vulva epidermis can be completed in the skin without suture removal, and the whole perineal lateral incision suture operation takes about 30 minutes. Now there is pudendal nerve block anesthesia, perineum is rich in blood vessels, which is easy to form hematoma, and the lateral incision can heal in 3-5 days.
Recently, I read a book called Notes of Obstetricians and Male Doctors, which contains an introduction about lateral incision.
One of my female classmates is a gynecologist, and I also learned something from her.
I think this problem can be understood from the following three angles:
1 What happens if you don't play sideways?
Normal women also have perineal lacerations during childbirth. The incidence rate is as high as 95%.
This laceration degree is divided into four grades, 1, grade 2 is lighter, 1 does not need sewing, and grade 2 needs sewing. But it recovered after suture and did not affect normal life.
The third and fourth grades are very serious. If it is not handled well, it will affect the future life. It will not only affect sexual life, but also cause fecal incontinence and affect the rectum.
However, it is the midwife's judgment whether the parturient will have lacerations or not, and there are several lacerations.
No experienced midwife can be 100% sure that she is right.
Why do most of them cut horizontally?
Side cutting is safer.
Lateral incision can speed up the second stage of labor, which is beneficial to both mother and child. Moreover, suturing after lateral incision will hurt, but it will not cause more serious laceration, which is good for parturient.
However, if it's only a slight tear, you can cut it horizontally for me. Is this appropriate?
But who can accurately judge whether you are slightly torn or severely torn?
Therefore, in order to be safe and not take responsibility, the doctor will default to lateral incision, or "judge" that the mother needs lateral incision.
Does lateral cutting affect life?
One of my classmates doesn't want to have a side cut before giving birth. She thinks it will affect her sex life and is afraid of pain.
I found a circle and specialized in making resources with acquaintances.
But in the end, I didn't give birth for a long time. Finally I cut it horizontally.
At that time, my stomach was very painful, and my attention was focused on the production. I didn't feel the pain of side cutting.
Recovery after suture does not affect sexual life.
Therefore, don't "look pale" when you listen to side details, and don't always think that there is a "conspiracy" in the hospital. If something is extremely harmful to health, our country will not let it exist for so long and so common.
That's my answer.
To sum up, there are many lacerations in natural childbirth, and hospitals often cut sideways to avoid more serious lacerations. This will make the production smoother and benefit both adults and children.
Transverse cutting will not affect the subsequent life.
When it's time to cut horizontally, cut horizontally. Listen to the midwife. Not as terrible as you think.
I hope it helps you. Thanks for reading.
During delivery, the doctor will decide whether it is necessary to perform perineal lateral incision according to the actual situation (such as fetal position is not conducive to delivery, fetal distress, need to use forceps for midwifery, etc.). ).
If the lateral incision is decided, the purpose is to enlarge the vagina and prevent more serious perineal tear.
After the mother gives birth to the baby and placenta, the doctor will sew up the incision. After the baby is born 1 month, the perineal incision can be completely healed.
It has a certain impact on the life of husband and wife. First, the psychological worries and doubts of pregnant women. The second is wound healing. Worried that the perineum is not tight enough, mothers can do Kegel exercises more to strengthen the pelvic floor muscles and make themselves stronger.
Hello, I'm a mother without a side cut. Before giving birth to a child, I also did a lot of homework and learned sidecutting, and I was quite scared.
When I went to the hospital to give birth, I specifically told the midwife that I didn't want to stand aside. Our midwife said to me, "Our hospital doesn't stand aside, so the parturient will naturally cry. Lateral incision will cut off muscle texture, which is not conducive to the recovery of parturient, but the situation in each hospital is different. In some hospitals, every woman will be marginalized. "
Later, when I gave birth, the midwife always taught me to push hard and help me. Finally, it was torn, but there was no side incision and stitches. As for my recovery, I think it's ok, but I was afraid that the wound would crack a few months ago, and then I gradually felt better. In fact, the wound has already healed, because it has not experienced lateral incision, so it is impossible to compare.
I gave birth to a daughter and a son here, and the woman who was born there around me really didn't have a side cut. I heard that sometimes, in order to make the parturient give birth quickly, the doctor will do a side cut. Some parturients actually have the conditions not to do lateral incision, but if the child is too old, it is better to do lateral incision, because too serious tearing may affect postpartum life. If the child is not very old and the maternal conditions are better, natural tears are better than lateral incision.
It is not necessary to cut sideways during delivery, and the doctor will choose according to the maternal situation. Lateral incision is to prevent perineal tear of pregnant women, protect pelvic floor muscles and avoid serious sequelae such as fecal incontinence caused by severe tear.
When the baby weighed more than 7 kg, the doctor gave me a gentle knife and cut it horizontally. Because it was covered up by the pain during childbirth, the doctor didn't feel anything when he cut sideways. The doctor will prescribe soaking medicine to disinfect your wound every day. Fast people can recover in a week or two, and slow people can recover in a month without any sequelae. So for the side cut of natural delivery, follow the doctor's advice, don't worry too much, and pay attention to safety when you come!
There was a side incision when Dabao was born, because Dabao had an umbilical cord around his neck. In order to speed up the labor process and avoid the baby's lack of oxygen, I chose lateral incision.
The lateral incision wound is neat and easy to sew, and the recovery is better than tearing the wound.
Generally speaking, primiparas are more prone to lateral incision, because the perineum is tight at primipara. In addition, some expectant mothers have long perineum, hard and tough tissues or poor development, inflammation and edema, or the perineum failed to fully expand during emergency labor. It is estimated that the fetal head will have a laceration of more than II degree during delivery, and they will be asked by the doctor to make a lateral incision.
Doctors will also judge according to other conditions, such as the fetus is too large, the fetal heart rate drops at the end of delivery, or elderly women, or when they are complicated with some diseases. In order to have a healthy fetus, and to reduce the harm to the mother and reduce the risk, it is necessary to cut the delivery as soon as possible to reduce the physical consumption of the mother.
There was no side cut when giving birth to a second child.
[Cover your face]
A simple and rude answer, let's take a look at my baby's birth date: 2020. 20. 20. 2. 22, isn't it amazing? My baby should be almost 2 years old. Haha, when I gave birth to the baby, I also gave birth naturally and was cut horizontally. In addition, there are several wounds, and I lost 800 ml of blood. I can't stand up for two or three days. As long as it recovers in the second month, it basically has no effect. Only people who have given birth know that being a mother is really great.