What is Episiotomy?
An episiotomy is a straight cut through the muscle and connective
tissue in the perineal area to enlarge the opening of the
vagina. The decision to perform an episiotomy is usually made
as the baby's head begins to emerge.
is generally done in one of two ways:
cut made from the vagina towards the anus or
Mediolateral cut made from the vagina sloping out to one
episiotomy can be done under local anaesthetic although for
a small episiotomy, this is not always necessary as the pressure
of the baby's head on the perineum can numb the feeling. The
number of stitches required is related to the size and depth
of the cut. The larger the incision, the longer it will take
to heal, often causing tenderness, discomfort and swelling
for days, sometimes weeks afterwards. Since the incision is
made through both skin and muscle layers, careful repair of
the wound afterwards can take as long as an hour, often requiring
local anaesthetic.It is advisable to check the wound daily
for signs of possible infection and to make sure the stitches
haven't dropped out and become imbedded in the tissue.
Is an Episiotomy necessary?
Episiotomies are usually carried out when there are signs
of the baby becoming distressed, the birth needs to be hastened
or in cases of forceps delivery. For some women, the appropriate
use of episiotomy is important. Medical professionals believe
episiotomy reduces the chance of uncontrolled tearing of the
perineal tissue that can be more difficult to repair. It is
also believed that prolonged pushing can have a negative long-term
impact on pelvic floor function and that shortening the second
stage of labour is better for the baby. Though there are many
arguments against episiotomy, there are always situations
where an episiotomy is fully justified.
Problems arising from Episiotomy
Following are a few problems that might arise out of Episiotomy.
bleeding if performed too early, as the tissue has not thinned
Increased chance of further tearing the episiotomy incision
of stitches requiring antibiotics
Long-term discomfort during sexual intercourse
swelling, tenderness for days, even weeks afterwards
Excessive stress and pain far greater than that of superficial
Things You Can Do To Avoid Episiotomy
Certain birthing positions help you avoid episiotomy.
These include positions used in active birthing methods
such as being on hands and knees, squatting, upright and
using a birth stool.
during the last two months and regularly do your pelvic
Maintaining a good diet will promote the skin's elasticity
and will help avoid episiotomy.
should time your labour properly. The most common cause
of tearing is not allowing time for the perineum to stretch.
At this time, strong sensations encourage a desire to
push the baby out, though timing is crucial to allow the
surrounding tissue to stretch and thin in preparation.
Proper timing will help avoid episiotomy.
The pain related to episiotomy and tearing is primarily from
swelling and inflammation. Using icepacks can help. Soaking
in a salt or lavender bath can be soothing and relieving.
Rather than towel drying the area, a hair dryer can be useful.