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Labor & deliveryEpisiotomy
An episiotomy is an incision made in the perineum (the area of skin between the vaginal opening and the rectum) during delivery to enlarge the opening for the baby. About 50% of all women who delivery vaginally will have an episotomy. Whether you need an episiotomy will depend on the amount of tissue in your perineum, the size of the baby and you and your clinician’s preferences.
Research on the use of surgical episiotomy versus natural tearing shows both pro’s and con’s for both methods. The decision to opt for a surgical episiotomy over a natural tear must take into consideration your desires for a low intervention birth, maternal and fetal factors that may necessitate a quick birth and your clinician’s experience in repair of a natural tear. An episotomy is performed by first administering a local anesthetic given to reduce the pain from the episiotomy. It is surgically repaired after the birth of the baby before the delivery of the placenta. There is a risk of wound infection, which can be greatly reduced by keeping this area clean. If infection does occur, it can be easily treated with antibiotics. There are a two natural ways to help reduce the need for episiotomy both prior to and during labor. They are perineal massage and warm soaks. Perineal massage may be done in healthy pregnant women after 36 weeks and during labor. It involves gently stretching the vaginal opening with your thumbs while using a lubricant. This combined with warm soaks applied during labor helps the perineal tissue to stretch and relax, avoiding or reducing tearing at delivery. Ask your obstetrician or midwife about using perineal massage and warms soaks and use of episiotomy during labor.
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