Labor - episiotomy; Vaginal delivery - episiotomy
An episiotomy is a minor surgery that widens the opening of the vagina during childbirth. It is a cut to the perineum -- the skin and muscles between the vaginal opening and anus.
What are the Risks?
There are some risks to having an episiotomy. Because of the risks, episiotomies are not as common as they used to be. The risks include:
Sometimes, an episiotomy can be helpful even with the risks.
Will I Need an Episiotomy?
Many women get through childbirth without tearing on their own, and without needing an episiotomy. In fact, recent studies show that not having an episiotomy is best for most women in labor.
Episiotomies don't heal better than tears. They often take longer to heal since the cut is often deeper than a natural tear. In both cases, the cut or tear must be stitched and properly cared for after childbirth. At times, an episiotomy may be needed to ensure the best outcome for you and your baby.
You are pushing as the baby's head is close to coming out, and a tear forms toward the urethral area.
What Happens if I Need an Episiotomy?
Just before your baby is born and as the head is about to crown, your doctor or midwife will give you a shot to numb the area (if you have not already had an epidural).
Next, a small incision (cut) is made. There are 2 types of cuts: median and mediolateral.
Your health care provider will then deliver the baby through the enlarged opening.
Next, your provider will deliver the placenta (afterbirth). Then the cut will be stitched closed.
How can I Avoid an Episiotomy?
You can do things to strengthen your body for labor that may lower your chances of needing an episiotomy.
Keep in mind, even if you do these things, you may still need an episiotomy. Your provider will decide if you should have one based on what happens during your labor.
Baggish MS. Episiotomy. In: Baggish MS, Karram MM, eds. Atlas of Pelvic Anatomy and Gynecologic Surgery. 4th ed. Philadelphia, PA: Elsevier; 2016:chap 81.
Kilpatrick S, Garrison E. Normal labor and delivery. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 12.
Review Date: 4/19/2018
Reviewed By: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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