An episiotomy is minor surgery that widens the opening of the vagina during childbirth. It is a cut to the perineum -- the skin and muscles between the vaginal opening and anus.
There are some risks to having an episiotomy. Because of the risks, episiotomies are not as common as they used to be. The risks include:
Sometimes, an episiotomy can be helpful even with the risks.
Times when an episiotomy is often performed include:
Not every woman will need an episiotomy during childbirth. Many women get through childbirth without tearing on their own, and without needing a cut.
Episiotomies don't heal better than tears. They often take longer to heal since the cut is usually deeper than a natural tear. In both cases, the cut or tear must be stitched and properly cared for after childbirth.
Just before your baby is born, and as the head is about to crown, your doctor or midwife will give you a shot to numb the area (if you haven’t already had an epidural).
Next, a small incision (cut) is made. There are two types of cuts: median and medio-lateral.
Your doctor will then deliver the baby through the enlarged opening.
You can do things to strengthen your body for labor that may lower your chances of needing an episiotomy.
Keep in mind, even if you do these things, you may still need an episiotomy. Your doctor or midwife will decide if you should have one based on what happens during your labor.
Hartmann K, Viswanathan M, Palmieri R, Gartlehner G, Thorp J Jr, Lohr KN. Outcomes of routine episiotomy: a systematic review. JAMA. 2005;293(17):2141-2148.
American College of Obstetricians-Gynecologists. Episiotomy. Clinical Management Guidelines for Obstetrician-Gynecologists. ACOG Practice Bulletin. 2006;71.
Carroli G, Mignini L. Episiotomy for vaginal birth. Cochrane Database of Systematic Reviews. 2009;1:CD000081.
Cunningham FG, Leveno KJ, Bloom SL, et al. Normal labor and delivery. In: Cunnigham FG, Leveno KL, Bloom SL, et al, eds. Williams Obstetrics. 23rd ed. New York, NY: McGraw-Hill; 2010:chap 17.
Updated by: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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