An episiotomy is a cut that the doctor or midwife makes in the perineum (say “pair-uh-NEE-um”)—the skin and muscle between the vagina Click here to see an illustration. and anus. This cut is made just before the baby’s head is delivered. It makes the opening of the vagina larger. It may be done to help deliver the baby or to prevent deep tears around the vagina. After delivery, the doctor sews the cut closed.
There are times when this cut is needed. Even though your perineum is made to stretch and be flexible during childbirth, a baby that is larger than normal or is in the wrong position can stretch it too far. If the doctor uses instruments such as forceps, they can add to the pressure. If it looks like the birth is going to cause more than a few small tears, you may need an episiotomy.
An episiotomy may also be needed if the baby is in trouble and needs help to be born quickly.
Many doctors no longer use episiotomies routinely, but a few still do. Although midwives can do episiotomies, they are much less likely to.
What are the risks of episiotomy?
* Episiotomy cuts are longer and deeper than small tears, so they may take longer to heal. Women who have episiotomies are likely to have more pain in the weeks or months after childbirth.2
* Women who have an episiotomy may be more likely to have pain with sex in the months following childbirth. Because of this, they are slower to resume having sex.4
* Women who have episiotomies are more likely to have deep tears, which can happen when the baby’s head puts pressure on the cut and makes it longer and/or deeper.1 Deep tears damage the anal sphincter and/or rectal wall. When this area is damaged, you may lose some control of your stools or gas. Women who have had an episiotomy may be more likely to have this problem.4
What are the risks of not having an episiotomy?
* Without this cut, it may take a few more contractions to push the baby out.
* Some women, especially first-time mothers, will have some tearing. But the tears are likely to be smaller than an episiotomy cut and should heal in 2 or 3 weeks.
* Although it is not likely, it’s possible that you could have a serious tear that hurts more and heals more slowly than an episiotomy cut.