Hello!  I gave birth 11 months ago and I am due with my second in 4 months.  During my first birth, my doctor cut an episiotomy for no reason other than it was his routine.  And then I feel like he stitched me to be smaller than before.  I am concerned for my second birth because I really want to avoid an episiotomy, but I'm afraid I just won't stretch because of the scar tissue and because I feel smaller.  What do you think?  Thank you so much.  Rachel

It is possible that he did, although I would have thought the "husband's knot," would have disappeared long ago and good riddance to it--but then, again, so should have episiotomy itself except in rare circumstances. I wouldn't be too anxious, though. Part of the adaptation to pregnancy is that all elastic tissues become extra stretchy and the walls of the vagina actually develop little folds to help it stretch around the baby. You may wish to engage in perineal massage if that is acceptable to you. (Here is one article with instructions that came up when I ran a search.) And, of course, find a different care provider if you are still with the same one. If your previous doctor is still cutting routine episiotomies, not to mention sewing up women to be extra tight, you can bet other practices are also not in line with best obstetric practice. If you need some guidelines on how to pick a new care provider, download this brochure from the Coalition for Improving Maternity Services website. You may also wish to see what other women think of care providers in your area and perhaps contribute your own story.

-- Henci