What Is an Episiotomy?
Labor & Delivery
Obie Editorial Team
An episiotomy is a small surgical procedure done during labor. During the procedure, a cut made into the perineum, the skin, muscles, and area between the vagina and the rectum in order to enlarge the vaginal opening during delivery. An episiotomy is a commonly performed surgery during delivery. The incidence varies significantly among hospitals, doctors, and countries.
For decades, episiotomies have been routinely performed to help speed delivery during the pushing phase of labor and to prevent tears to the vagina, especially serious tears that may stretch to the urethra or the anus. An episiotomy was also thought to lessen trauma to the baby and protect the vaginal muscles.
However, most doctors now agree that episiotomies should no longer be performed routinely. One large study showed that routinely cutting an episiotomy increases the risk of tears in the back of the vagina, but reduces tears in the front. Based on these results, the World Health Organization, among other groups, recommends avoiding a routine episiotomy and to only perform it when it is indicated in the following circumstances:
Median episiotomy: The median incision goes straight down the vagina toward the anus.
Medio-lateral episiotomy: This is made at an angle from the vagina to the anus. The mediolateral is considered less likely to tear through to the anus but is more difficult to repair and takes longer to heal than the median.
An episiotomy is usually stitched closed immediately after delivery, and most doctors use stitches that will self-absorb.
After delivery, try these tips for pain relief while the incision is healing: