Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
An episiotomy is an incision performed between the vagina and the rectum that is used to increase the size of the opening of the vagina to assist in
delivery of a baby.
How common is episiotomy?
An episiotomy is performed in about 40% of vaginal deliveries in the United States, but the prevalence of episiotomy has been decreasing in recent years. For example, 1.6 million episiotomies were performed in 1992 and only 716,000 in 2003. Some countries have significantly lower episiotomy rates than the U.S. In general, episiotomy is less common in Europe than in the U.S.
How is an episiotomy done?
The usual cut (incision) for an episiotomy goes straight
down and typically does not involve the muscles around the rectum or the rectum
itself. Anesthesia in the form of nerve blocks or local injections of anesthetic
are given if the patient has not received regional anesthesia (such an epidural) for the delivery.
What are the advantages of an episiotomy?
An episiotomy can decrease the amount of pushing the mother must do during delivery. It can also decrease trauma to the vaginal
tissues and expedite delivery of the baby when delivery is necessary quickly.
Doctors who favor episiotomies argue that a surgical incision is easier to
repair than a spontaneous irregular or extensive tear, and is likely to lead to a more favorable outcome with fewer complications.
How is an episiotomy repaired?
The repair is straightforward and is fairly simple to perform. The incision is repaired by suturing (sewing) the wound together.
There are many symptoms involved in the 1st, 2nd and 3rd trimesters of pregnancy. The first early pregnancy symptom is typically a missed period, but others include breast swelling and tenderness, nausea and sometimes vomiting, fatigue and bloating. Second trimester symptoms include backache, weight gain, itching, and possible stretch marks. Third trimester symptoms are additional weight gain, heartburn, hemorrhoids, swelling of the ankles, fingers, and face, breast tenderness, and trouble sleeping. Read more to learn about recommended procedures and tests for each stage of a healthy pregnancy.
Endometriosis is the growth of cells similar to those that form the inside of the uterus, but in a location outside of the uterus. Endometriosis implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. They can also be found in the vagina, cervix, and bladder. Treatment of endometriosis can be with medication or surgery.
Pregnancy planning is important to help prevent exposure of the mother and fetus to potentially harmful medications and substances during the early days, and throughout the pregnancy. Nutritional planning, prevention of birth defects, conditions such as high blood pressure, heart disease, diabetes, and kidney disease need careful monitoring. Gestational diabetes, preeclampsia, and pregnancy induced hypertension are conditions that may arise during pregnancy. Immunizations, inherited disorders, exercise, air travel, intercourse, and birth control are important factors to consider when planning a pregnancy.
Pregnancy can bring challenges like weight gain, stretch marks, varicose veins, heartburn, constipation, hemorrhoids, problems sleeping, and wondering if it is safe to have sex while pregnant. Learn how to manage and move through these challenges during pregnancy.
Women experience and tolerate pain differently. For some pregnant women, focused breathing is all they need to get through labor and childbirth; but for others, numbing of the pain is desired.
There are a number of different medications a woman can take during labor and childbirth. It is important for you to learn what pain relief options are available. Please discuss the options with your health care provider well before your "birth day" so that when you are in labor you understand the choices.
Pregnancy planning can address issues of nutrition,
vitamins, body weight, exercise, and potentially harmful medications and
illnesses as well as immunizations and genetic counseling.
Women who take folic acid at least four weeks prior to
conception can reduce their baby's risk of birth defects of the spinal cord
and skull by 70%.
Alcohol has been implicated in infertility, early
miscarriage, and birth defects.
Certain acne medications and other prescription and OTC
medications can cause birth defects.
Babies of older women have an increased risk of
having chromosomal abnormalities.
The timing of sexual intercourse in relation to ovulation does not
influence the gender of the baby.
What is pregnancy planning and why is it important?
Having a baby is one of the most important events in a woman's life...
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