Episiotomy and Pregnancy

An episiotomy is a procedure where the skin (the perineum) between the vagina and the anus is cut. It is done occasionally to enlarge the vaginal opening so that a baby can be more easily delivered.

The following information has been adapted from the websites listed at the bottom of this page.

When your baby's head is stretching the opening of your vagina, your health care provider will numb the area with an anesthetic unless you have already been given a block for pain.  Your health care provider will then make an incision into the tissue between the opening of your vagina and your rectum.  

After you deliver your baby, the health care provider will stitch the incision.  The stitches will not need to be removed.  They will gradually dissolve after about 10 days. 

Indications   

An episiotomy may be if:

Benefits of an episiotomy 

The benefits of an episiotomy are:  

Risks   

Episiotomies were once routinely performed to prevent vaginal tears during delivery. Today, there is a great deal of controversy regarding the procedure. Some women experience prolonged pain with intercourse after the procedure.  Other risks include:

After an episiotomy

The incision should heal quickly, although you may have some pain and swelling.  This can be relieved by:  

• ice on the sore area for the first 24 hours
• sitz baths (sitting in bath water) several times a day 
• sprays or pads that contain a numbing medicine 
• pain medications (such as acetaminophen or ibuprofen).

Controversy

In various countries, routine episiotomy has been accepted medical practice for many years. Since about the 1960s, routine episiotomies are rapidly losing popularity among obstetricians and midwives in Europe and the United States.

Having an episiotomy may increase perineal pain in the postpartum period, resulting in trouble defecating. In addition it may complicate sexual intercourse after pregnancy by making it painful and replacing erectile tissues in vulva with fibrotic tissue.