Epsiotomy

The term episiotomy is given to the procedure where your healthcare provider makes an incision or cut in the vaginal opening in order to widen the opening making it possible for the baby to be delivered.

When is an episiotomy needed?

These situations do not mean that you must have an episiotomy, but they do increase the chances that you may experience one:

  • The vaginal opening is smaller than the baby’s head.
  • The baby is coming and the perineum has not had enough time to change.
  • There is a concern or distress with your baby
  • Labor is not proceeding well and your healthcare provider needs to use forceps or a vacuum.
  • Your baby is in a breech presentation and there is a complication during delivery

How is the episiotomy procedure performed?

You will either recieve an epidural or a local anesthesia in the perineum. The first cut is downward away from the vagina and the second cut is straight down into the perineum. You will probably not feel the cuts during the procedure, but they will be sore afterwards.

Reducing your chances for an episiotomy:

You may take the following steps to lower your chances of having an episiotomy:

  • Eat well balanced meals which helps your skin cooperate with labor
  • Kegel exercise help your vaginal and pelvic area prepare for labor.
  • Using warm compresses, massage, and support during delivery
  • Avoid lying on your back while pushing

What side effects or risks are related to an episiotomy?

An episiotomy is a fairly safe procedure, but there are risks related. Each of the following is a possible concern following an episiotomy:

  • Infection
  • Bruising
  • Swelling
  • Bleeding
  • Extended healing time
  • Painful scar which may require a period of abstinence from sexual intercourse
  • Future problems with incontinence

Care options following an episiotomy:

Episiotomy surgeries usually leave you with at least discomfort if not pain. Your muscles have been cut, so it is not unusual to have pain. The following are some steps that you can take to try and manage or lessen the pain that you experience after having an episiotomy:

  • Cold packs on the perineum.
  • Take a sitz bath.
  • Use medication such as Tucks Medicated Pads.
  • Avoid sexual intercourse
  • Pat dry the area, instead of wiping
Last Updated: 09/2008

Compiled using information from the following sources:

William’s Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 17.

Danforth’s Obstetrics and Gynecology Ninth Ed. Scott, James R., et al, Ch. 2.

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