An episiotomy is a procedure many expectant mothers hear about but may not fully understand. It can feel scary or confusing, especially if you’re not sure when or why it might be done. To help you feel more informed and confident about your birth plan, here’s what doctors and midwives want you to know about episiotomy—from what it is to how to recover.
What is an episiotomy?
An episiotomy is a small cut made by a doctor or midwife in the perineum—the area of skin and muscle between the vagina and the anus. This is done during childbirth to help make the vaginal opening larger and allow the baby to come out more easily.
Why would a doctor perform an episiotomy?
In many cases, the body naturally stretches to allow the baby to be born. However, sometimes doctors perform an episiotomy for specific medical reasons, such as:
- The baby is in distress: If the baby’s heart rate drops and delivery needs to happen quickly, an episiotomy can speed up the process.
- Preventing severe tearing: Doctors or midwives may perform a controlled cut to avoid unpredictable or jagged tearing.
- The baby is large: If the baby’s head or shoulders are too big, an episiotomy may help.
- Assisted delivery: If forceps or a vacuum are needed to help deliver the baby, an episiotomy may make this process safer and easier.
Types of episiotomies
There are two main types of episiotomies:
- Midline episiotomy: The cut is made straight down from the vaginal opening. This type is easier to repair but can extend into the anus if it tears further.
- Mediolateral episiotomy: The cut is made at an angle. It lowers the risk of tearing into the anus but may take longer to heal.
Your doctor or midwife will decide the best option based on the situation during childbirth.
Are episiotomies common?
Years ago, episiotomies were routine during childbirth. Today, they are far less common. Many healthcare providers now focus on natural ways to help the body stretch, such as:
- Perineal massage during pregnancy and labor
- Using warm compresses on the perineum during childbirth
- Encouraging a slow, controlled delivery
The goal is to avoid unnecessary cuts and let the body adapt naturally when possible.
How can you prepare to avoid an episiotomy?
While you can’t always prevent an episiotomy, there are things you can do to reduce your chances of needing one:
- Do perineal massages: Starting around 34 weeks of pregnancy, gently massage the perineum to improve elasticity.
- Practice Kegel exercises: These strengthen the pelvic floor muscles and prepare your body for childbirth.
- Discuss your birth plan: Talk to your doctor or midwife about your preference to avoid an episiotomy unless medically necessary.
- Stay active during labor: Walking, changing positions and avoiding long periods of lying on your back can help the baby move through the birth canal naturally.
What happens after an episiotomy?
If an episiotomy is needed, it will be repaired right after childbirth. Your doctor or midwife will use dissolvable stitches to close the cut, and the area will heal over time. Here are some tips for recovery:
- Manage pain: Use ice packs, sitz baths, or pain relievers as recommended by your doctor.
- Keep the area clean: Use warm water to rinse the area after using the bathroom.
- Avoid straining: Eat high-fiber foods and drink plenty of water to prevent constipation.
- Rest and heal: Avoid heavy lifting or intense physical activity until your doctor says it’s safe.
Postpartum recovery is different for everyone. Most women heal within a few weeks, but it’s important to let your body recover fully.
Is an episiotomy safe?
An episiotomy is generally a safe procedure when done for the right reasons. However, like any medical procedure, it does carry some risks, such as infection, pain, or a longer healing time. This is why healthcare providers only recommend it when absolutely necessary.
Learn more
If you have concerns or questions about episiotomy, talk to your doctor or midwife. The more informed you are, the more confident you’ll feel on your childbirth journey.
For more information about NGMC’s Childbirth Education classes, click here.
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