Amniotomy
This is the artificial rupture of membranes. It is supposedly done to "speed up" labor, though most studies say that this is not true for most women. 75 of the time your water will break past nine centimeters. Amniotomy may also be used to assess if the baby has passed meconium or to allow the insertion of internal monitoring.
It is done by placing a amnihook (looks very similar to a long crochet hook) inside the vaginal during a vagina exam and scratching the bag until it ruptures.
Drawbacks to this can include:
- Increased risk of infection
- Lack of cushion for the baby's head
- Slim risk of cord prolapse (life threatening emergency)
- Increased intervention, and limited mobility
There are other ways to speed labor, including walking, nipple stimulation, position changes, etc. Amniotomy may also be used as an induction technique.
Episiotomy
This is the surgical cut in the perineum to enlarge the area to allow the baby to pass. Recent studies have shown that this is usually not necessary and can actually cause more problems than it prevented.
Most studies agree that rates of episiotomy above about 10 re excessive. Many state that times small cuts that are made actually lead to an increase in larger tears (3rd and 4th degree), greater risk of infection, and a longer and more painful recovery.
Episiotomies should be saved for complications such as fetal distress, to angle a cut or tear, etc. Talking to your practitioner about your feelings, and theirs, will help you in finding the path that is right for you.
There are many things that can be done to prevent the need for an episiotomy and tearing, including positioning, massage of the perineum (both prenatally and during the birth), a slow, controlled pushing stage, and practitioner manipulations.
