Episiotomies, although commonly performed and potentially beneficial, can be quite uncomfortable and have risks for the woman. It is important for expectant mothers to ensure they educate themselves prior to labor about the benefits and risks of an episiotomy to ensure they are making an informed decision for themselves and their baby.
What is an episiotomy?
An episiotomy is a surgical cut through the perineum (the tissue between the vaginal opening and the anus). This cut is usually made with scissors, however, scalpels may be used to perform and episiotomy, but their use is rare. This cut may be straight up and down, however, it may also go off to the left or right side.
How is an episiotomy performed?
Typically, an episiotomy is not performed until the skin around the vaginal opening is stretched tightly, not allowing much give. If an episiotomy is to be performed and the mother is not under the effects of regional anesthetics, she will be administered an injection of a local anesthetic near the site of the episiotomy. The physician will then insert one blade of the scissor between the baby’s head and the mother’s vaginal tissue and create a short incision downwards.
What are some reasons an episiotomy may be needed?
An episiotomy may be needed if the birth is happening quickly and the perineum has not had time to stretch. It may also be needed if the baby’s head is simply too large and the vaginal tissue is unable to stretch to accommodate it. If forceps or vacuum extraction are being used to assist the delivery an episiotomy may be necessary as well. An episiotomy may also be necessary is the baby is breech or showing signs of fetal distress.
What are the advantages of an episiotomy?
By performing an episiotomy, the physician has more control over where the incision is and is able to keep it in one smooth clean cut, making it easier to repair afterwards than a tear.
An episiotomy may help prevent tears.
By performing an episiotomy, the woman’s labor may be sped up and her baby may be delivered sooner.
In cases where the baby is premature, or otherwise fragile, performing an episiotomy may spare some of the pressure on the baby’s head from the perineum.
What are the disadvantages of an episiotomy?
Although an episiotomy may prevent tears, they may still occur. An episiotomy may become infected and may even bleed and bruise. Episiotomies may take longer to heal, thus lengthing the recovery time after birth and postponing the woman’s ability to resume sexual relations with her partner. An episiotomy may also form painful scar tissue that may make sexual intercourse uncomfortable or even painful for an extended period of time.
The woman may suffer from bladder or rectal problems later as a result of the episiotomy, including incontinence.
“Episiotomy : American Pregnancy Association.” Promoting Pregnancy Wellness : American Pregnancy Association. Web. 25 Sept. 2010.
Johnson, Robert V. Mayo Clinic Complete Book of Pregnancy & Baby’s First Year. New York: W. Morrow and, 1994. Print.Book
Kitzinger, Sheila. The Complete Book of Pregnancy and Childbirth. New York: Knopf, 1989. Print.