Episiotomy also known as perineotomy is an incision made in the perineum - the tissue between the vaginal opening and the anus - during childbirth. Although an episiotomy was once a routine part of childbirth, that's no longer the case. Routine episiotomies are no longer recommended. Still, the procedure is warranted in some cases. Your health care provider might recommend an episiotomy if:
- Extensive vaginal tearing appears likely
- Your baby is in an abnormal position
- Your baby is large (fetal macrosomia)
- Your baby needs to be delivered quickly
If you need an episiotomy and you haven't had any type of anesthesia or the anesthesia has worn off, you'll likely receive an injection of a local anesthetic to numb the tissue. You shouldn't feel your health care provider making the incision or repairing it after delivery.
For years, an episiotomy was thought to help prevent more extensive vaginal tears during childbirth - and heal better than a natural tear. The procedure was also thought to help preserve the muscular and connective tissue support of the pelvic floor. Today, however, research suggests that routine episiotomies may not prevent these problems after all. Recovery is generally uncomfortable, and sometimes the surgical incision is more extensive than a natural tear would have been. Infection is possible. For some women, an episiotomy causes pain during sex in the months after delivery. An extensive episiotomy might also contribute to fecal incontinence after childbirth.
