Episiotomy-Assisted Vaginal Birth

I just recently delivered a woman of her third baby - a baby girl. I had been called to see an out-patient arrival and so was headed for the consulting room, when I heard the screams coming from upstairs and so I detoured.

The baby's head was already crowned - you could see locks of hair and scalp right at the introitus (vaginal entrance) even during the relaxation phase of uterine contractions. She was tense and fidgety at this final phase of the 2nd stage of labour - I've noticed sometimes, our midwives do not do a good enough job of managing the patient to get her calmer at this crucial phase.

Soon, I gave a deep cut to the vagina with the episiotomy scissors during the final contraction and push, which then saw the whole head come right through. The contractions still strongly present, each shoulder in turn, and then the rest of the body, followed through; the baby wailing its protest in both my hands, almost immediately.

Handing the screaming new-born over to the midwife, I promtly repaired the wedge-shaped, neat vaginal cut, with 2-0 chromic sutures after locally anaesthetising with Xylocaine.

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