Episiotomy - Surgical Cut During Delivery
Surgical incision in perineum to widen vaginal opening during delivery - when it's necessary.
Overview
An episiotomy is a surgical cut made in the perineum (tissue between vagina and anus) to enlarge the vaginal opening during delivery. Once routine, it's now only done when medically necessary.
Episiotomies are no longer routine because natural tears often heal better than surgical cuts. They're reserved for situations like baby in distress needing quick delivery, shoulder dystocia, or to prevent severe tearing.
The cut is made with scissors and repaired with dissolvable stitches after delivery. Recovery involves keeping area clean, using ice packs, and taking stool softeners.
💡 Key Points
- •Surgical cut in perineum during delivery
- •No longer routine - only when medically necessary
- •Two types: midline and mediolateral
- •Made with local anesthetic
- •Repaired with dissolvable stitches
- •Recovery similar to tearing
📖 What to Know
- →Only 12% of vaginal births involve episiotomy now
- →Used when: baby in distress, shoulder dystocia, preventing severe tear
- →Natural tears often heal better
- →You can decline routine episiotomy
- →May not prevent all tearing
- →Heals in 2-3 weeks
- →Can have sex again once healed (usually 6 weeks)
✓ How to Prepare
- →Discuss provider's episiotomy rate and philosophy
- →Include preference in birth plan
- →Perineal massage in late pregnancy may help
- →Understand when it may be medically necessary
- →Don't fear tearing - most are minor
- →Prepare postpartum care supplies: peri bottle, ice packs
- →Know that refusal of routine episiotomy is reasonable
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