Labor - episiotomy; Vaginal delivery - episiotomy
There are some risks to having an episiotomy. Because of the risks, episiotomies are not as common as they used to be. The risks include:
Sometimes, an episiotomy can be helpful even with the risks.
Many women get through childbirth without tearing on their own, and without needing an episiotomy. In fact, recent studies show that not having an episiotomy is best for most women in labor.
Episiotomies don't heal better than tears. They often take longer to heal since the cut is often deeper than a natural tear. In both cases, the cut or tear must be stitched and properly cared for after childbirth. At times, an episiotomy may be needed to ensure the best outcome for you and your baby.
You are pushing as the baby's head is close to coming out, and a tear forms toward the urethral area.
Just before your baby is born and as the head is about to crown, your doctor or midwife will give you a shot to numb the area (if you have not already had an epidural).
Next, a small incision (cut) is made. There are 2 types of cuts: median and medio-lateral.
Your health care provider will then deliver the baby through the enlarged opening.
Next, your provider will deliver the placenta (afterbirth). Then the cut will be stitched closed.
You can do things to strengthen your body for labor that may lower your chances of needing an episiotomy.
Keep in mind, even if you do these things, you may still need an episiotomy. Your provider will decide if you should have one based on what happens during your labor.
Kilatrick S, Garrison E. Normal labor and delivery. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 12.
Rosenthal MT. Episiotomy and repair of the perineum. In: Pfenninger JL, Fowler GC, eds. Pfenninger and Fowler's Procedures for Primary Care. 3rd ed. Philadelphia, PA: Elsevier Mosby; 2011:chap 166.
Last reviewed on: 5/16/2016
Reviewed by: Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.