building knowledge for a positive birth experience

Perineal Repair: what I left out of my birth stories

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In both of my birth stories (here and here), I left out an important part of my experience.  After wonderful labors and births, after delivering the placentas, and with my babies healthy, and in my arms, I realized that there was still another part I had to go through.  I tore in both births, not badly, but enough to require some repair (stitches).  Something strange and unexpected happened both times: the injection to numb the area didn’t work.  In both cases, my care provide gave a second injection of numbing medication to ensure I wouldn’t feel the repairs, but the process of figuring that out was very unpleasant (to say the least).

I’m writing about this because it is something that was a bad experience for me, in the midst of generally wonderful, positive, and satisfying birth experiences.  After having this happen to me twice, I did a little research, and found that there is a good alternative pain relief medication in a topical cream form, that is significantly more effective for more women.  EMLA cream provides better pain relief, and more women report higher rates of satisfaction with EMLA cream vs. traditional injected medication. Not to mention that in an unmedicated birth, the injection of numbing medication itself is quite painful.

I was unable to find any good data on how frequently the injection numbing medication fails women as pain relief for perineal repair.  But it seems that the EMLA cream would benefit all women, diminish this possibility, and certainly result in less pain because of there being no injection.

I hope that sharing this experience does not increase the fear surrounding childbirth, but instead, increases our ability to advocate for ourselves.  In my first birth experience, I didn’t know that the repair should not be painful, and didn’t realize that there were alternatives for pain relief.  In my second birth experience, I was surprised that it could be happening again, but I (along with my friend and husband) advocated for myself, and suffered much less.

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