What it is:
Episiotomy is a surgical cut that is made to the perineal skin (at the base of the vagina) during the pushing stage of labor. There are two main types of cuts. A midline episiotomy is cut straight down towards the anus. A mediolateral is cut to the side.
The cut made by an episiotomy is equivalent to a second degree tear, meaning that both skin and muscle are cut.
Why it is used:
In cases of fetal distress, an episiotomy may shorten pushing by 5 to 15 minutes allowing for the baby to be born faster.
If the perineum is not stretching, some health care providers will recommend an episiotomy.
Episiotomies cause increased pain during recovery. The average length of healing time for an episiotomy is 3 months, compared to 1 month with a tear.
Episiotomies increase the incidence of deep tears into the anal sphincter.
Because skin is cut, there is an increased risk for infection.
Other Options to Consider:
- Some women prefer to try their luck for a tear, knowing that the average tear is only a first degree (meaning only skin is injured) and heals in about a month.
- Choose positions that speed labor and reduce the incidence of pelvic floor problems such as squatting.
- Perineal massage during pregnancy which can help the mother learn to relax rather than tense during the burning and stretching sensations that accompany crowning.
- Pelvic Floor Exercises during pregnancy to make the pelvic floor stronger and more elastic.
- Spontaneous Pushing, where you push only as strong as your body says is necessary for only when your body gives you the urge.
- Warm compresses to encourage the stretching of the perineum.
- Avoid a local anesthetic which will cause the perineal tissues to swell decreasing the flexibility and increasing the chance of a tear.
- Use oil and massage on the perineum as the baby is crowning to promote stretching.
What would you like next?
Understand what changes are being assessed during a cervical exam.
Find local resources in the The Natural Childbirth Directory.
Learn about comfort measures to help you manage labor.
Discover ways to stay comfortable during pregnancy.