When preparing for childbirth, every woman will feel extremely happy and proud, but at the same time, she will feel uneasy. Don't let those difficult questions bother you again. More scientific and comprehensive understanding can make you more confident.

　　 Common birth surgery

　　 1、 Fuzzing

Hair removal and enema are generally performed in most obstetric hospitals or clinics in China. The hair removal during production is usually only carried out near the perineum (from the anus to the vagina), rather than all the pubic hair. The purpose of hair removal is to make it easier to deal with perineal wounds after delivery if the perineum is torn during production. This step is not absolutely necessary, but it is still helpful for obstetricians to deal with perineal wounds.

　　 2、 Enema

The enema only allows the stool close to the rectum to be discharged first, so as to prevent the puerpera from contaminating the perineum wound during the delivery process, increasing the chance of possible infection. The degree of complete clearance of the whole intestine is quite different between the enema before production and the general surgery or gastrointestinal examination. This kind of enema will not cause discomfort to the puerpera. This step is not absolutely necessary.

　　 3、 Episiotomy

Periiotomy is an operation that uses surgical scissors to cut the perineum to expand the birth canal to assist in delivery. In the following three cases, obstetricians usually need to use scissors for vaginal surgery.

1. If the fetus shows signs of distress, it is necessary to deliver the fetus as soon as possible.

2. If the labor process is too long and needs to be assisted by forceps or vacuum suction.

3. There is dystocia, such as breech delivery or shoulder dystocia (the baby's shoulder is stuck and cannot come out).

When performing episiotomy, the general procedure is to apply local anesthetic first and then perform it. The incision can be cut in a straight line from the back of the perineum, or in a diagonal line from the middle of the perineum. After the fetus and placenta are completely delivered, they will be repaired by surgical suture. Generally speaking, the perineum of primipara is tight. If the fetal head is also large, it is easy to lengthen the second stage of labor (from the time when the cervix is fully opened to the birth of the fetus) without perineotomy. Sometimes such a situation is a risk to the fetus and the mother.

However, if it is a multipara or a primipara whose perineum is already relatively loose, the probability of encountering the above situation is relatively small, so the necessity of perineotomy will be greatly reduced.

In addition, some studies have shown that during the second stage of labor, with the assistance of professional midwives, the use of appropriate uterine push down techniques and perineal massage can also reduce the necessity of perineotomy.

On average, the fetal head circumference is several times of the perineal orifice. Even if the perineum is not cut open, most of the conditions during labor will still lead to perineal dehiscence, but the direction of dehiscence is not certain; In some cases, the purpose of perineotomy is to "guide" the direction of the wound opening to avoid hurting the anal sphincter or rectum.

　　 Communicate with doctors and patients before delivery

However, as for the size of the wound and its recovery in the future, and the impact of related complications such as anal sphincter dysfunction, sexual pain, etc., whether there will be differences between natural dehiscence and perineotomy, the results obtained in different medical professional studies have not reached a consistent conclusion.

That is to say, it can not be concluded that the perineum will heal better in the future if there is an incision than if there is no incision, or there will be fewer sequelae in the future. It is precisely because of this that there has been quite a lot of discussion about whether "routine surgery" or procedures should be carried out in the production process recently, which has also triggered some controversy.

Recently, many national experts, scholars and officials of the Health Administration have discussed the above issues and made suggestions for reference. The more feasible way is to do a good job in medical communication before delivery, so that the pregnant women can understand the possible advantages and disadvantages, and choose to or not to implement it. If the hospital or doctor does not ask before delivery, the mother can also take the initiative to ask, and the hospital or doctor should be willing to cooperate; Some hospitals will also require to sign relevant consent forms in advance to reduce future disputes.

　　 Respect professional judgment during production

However, it should be emphasized that the individual situation of each woman is different, and many changes in the birth process cannot be completely predicted in advance, so obstetricians cannot predict whether it is "necessary" or "unnecessary" to perform relevant operations or steps before delivery.

Therefore, in the production process, the professional judgment of the doctors or nurses around you is the most important criterion.