Episiotomy

An episiotomy is a cut made to widen the opening of the vagina. It is done toward the end of labor to keep the vaginal tissues from tearing as the baby is born. Sometimes an episiotomy can also help the doctor to deliver the baby quickly if the baby is in distress.

Who is a candidate for the procedure?

Usually, the doctor or midwife attending the birth decides whether to do an episiotomy. An episiotomy may be done when:

How is the procedure performed?

As the crown of the baby's head pushes through the vaginal opening, an anesthetic is injected in the mother's perineum to numb it. The perineum is the skin area between the vagina and anus. A cut 2 to 3 inches long is made there. After the baby is born and the placenta is delivered, the cut is stitched up.

What happens right after the procedure?

Most episiotomies are done to prevent large vaginal tears during childbirth. These tears heal slowly, often with poor results. Widening and tearing of the vagina may cause unneeded stretching. This may later lead to problems such as:

An episiotomy may help to prevent these problems.

What happens later at home?

Keeping the area clean is the key to preventing infection and to helping speed healing. The stitches will dissolve after a period of time and do not need to be removed.

To help heal an episiotomy, a woman should:

A woman should see her doctor for follow-up visits to check on how the episiotomy is healing.

What are the potential complications after the procedure?

Very rarely, an episiotomy may extend into the rectum. More stitches than usual would be required to repair the cut. The increased risks of this problem are:

Author:Eva Martin, MD
Date Written:
Editor:Crist, Gayle P., MS, BA
Edit Date:07/09/02
Reviewer:Kathleen A. MacNaughton, RN, BSN
Date Reviewed:10/28/02