Dooley Noted: 5/16/14
I have at least a handful of females inform me every week that they’ve experienced episiotomy during childbirth.
They state it casually, as if it’s just a normal, every day part of giving birth.
What bull they’ve been fed.
The pelvic floor helps you breathe, defecate, urinate, copulate, and ambulate. When you scar it with an incision, it doesn’t respond positively.
For those not versed on episiotomy, the procedure involves the surgical incision of the pelvic floor. The mother is told that this will prevent tearing of the pelvic floor during childbirth.
But why is this procedure necessary? Are women producing massive babies that will be tearing their way out of the uterus?
No!
I have a theory.
We ask our mothers early in gestation not to “lift anything heavier than 20-25 pounds” during gestation.
This helps the mother become nice and deconditioned for 9 months, right before she has to shove a watermelon through something the size of a lemon.
Then, we ask her to lay in the lithotomy position to birth her child. She is requested to lay on her back and compress the abdominal aorta, which provides blood flow to the abdominopelvic cavity and lower extremity.
But that’s not all.
Let’s encourage her to have an epidural, which not only kills pain but shuts down proprioceptive input below the area of injection. She will barely be able to feel where her pelvic floor exists in space, let alone encourage it to relax so she can pass a child through it.
This entire set-up sounds great, right? Have the baby on your back, and slice that pelvic floor.
Now, let’s allow the deconditioned new mother lift that baby as it grows larger by the day, expecting her to magically be strong enough to adapt.
Therapists like myself have to clean up this mess, when the pelvic floor dysfunction manifests as everything from incontinence to painful sex to compromising the breathing mechanism to global instabilities in gait.
For mothers intending to get pregnant:
1. Get strong.
2. Get great abdominal sequencing.
3. Squat, even if it’s bodyweight only. Your pelvic floor will thank you.
To the mothers who’ve experienced episiotomy:
Repeat 1-3. You will require extra help, since someone sliced into your pelvic floor, pretending like it was no big deal.
To the expectant mothers:
I hope you already had 1-3 in check.
If not, check out pronto all writings by biomechanist Katy Bowman.
For all the above, please get assessed and corrected by a movement professional.
As always, it’s your call.
-Dr. Kathy Dooley