An episiotomy is a surgical incision made  in the perineum to open the vaginal opening. This procedure helps in the delivery of the baby. It use to be a routine part of child-birth but no more.
 

 

What circumstances will require an episiotomy ?

 
You may need this procedure for the following reasons :

• birth is near and perineum hasn’t had time to stretch slowly
• the fetus is distress
• the head of the baby is too big for the vaginal opening
• mother is not able to control labor
• the mother needs the  forceps and vacuum assisted delivery
• the baby is in a breech position and there is a complication during delivery

How is an episiotomy done ?

 
You may not need any anesthesia if you have already had an epidural. Otherwise you may get a local anesthesia such as a pundal block in your perineum.

Your doctor may use a mediolateral cut in which case the incision is angled  down, away from the vagina and the perineum, into the muscle. With  midline cut on the hand , the cut is made straight down into the perineum, between the vagina and anus.

Are there any risks ?

 
The following side effects are possible :

• bleeding
• bruising
• infection
• extended healing time
• swelling
• problems with incontinence in the future
• painful scarring that may require abstinence from sexual intercourse for some time

How can I manage pain from episiotomies and tears?

 
Follow these steps to ease the pain from an episiotomy and tear.

• apply cold packs to the perineum
• use a personal lubricant when you resume sexual activities
• take a sitz bath ( it is a portable bath that is placed over the toilet and delivers warmth to the wound
• use medications such as  medication such as Tucks Medicated Pads
• use a squirt bottle instead of wiping after using the bathroom. You may also pat dry instead of wiping

How can I prevent an episiotomy ?

 
You can reduce your risk of an episiotomy by taking these steps

• eating healthy – good nutrition makes the skin healthy and make it stretch more easily
• engage in kegel exercises
• use warm compressions and support during delivery
• use perineum massage exercises
• a slowed second stage of labor where pushing is controlled