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Episiotomy: Will You Need One?

An episiotomy is the surgical cut which is made either before or during labor in the muscular area between the vagina and the anus – this area is called the perineum - to enlarge your vaginal opening.

Why is an episiotomy performed?

Your health care provider may make this cut either before or during the course of labor if he/she believes that there is a chance of your vagina tearing during childbirth. This is done because many health care provider believed that a clean incision would heal easier than a tear.

Are episiotomies still performed?

Over the last few years research has shown that making a clean incision does not in fact mean a quicker healing period. Recent research has shown that spontaneous tears generally recover in the same or less time - as well as bleeding less during childbirth. They also don't mean you will experience more discomfort during the recovery period.

Are there other complications associated with an episiotomy?

Other issues associated with episiotomies include:

Serious tears through the anal sphincter or even all the way through the rectum
More perineal pain after the birth, require a significantly longer recovery period
Lower strength of the pelvic floor muscles.
Increase the risk of anal incontinence.
Longer recovery period

Why might you need an episiotomy?

There are a few situations which may still warrant needing an episiotomy, and these are:

If your baby's heart rate shows there is a chance that she/he is not tolerating the last few minutes of labor and needs to be delivered as soon as possible.
Should your baby be big and your health care provider requires additional room to help deliver her/him.
If your health care provider is required to use forceps to help deliver your baby and requires additional room to work.
If your tissue is showing signs that you may tear in more than one place, then you health care provider may cut in one place, rather than risking multiple tears

Recovering from an episiotomy

If you required an episiotomy then you will have stitches in a very tender area – and this will take some time to heal. Usually within a week you will probably feel less pain in that area – although the minority of women feel pain for up to a month.

To help speed up recover you could make use of ice packs on your perineal area immediately after the to help numb the area and to reduce swelling

When can I have sex again?

Generally most health care providers will say that it takes four to six weeks after delivery. If you are experiencing pain during sex, then you may want to try using a water-soluble lubricant to help make sex more comfortable

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