Definition

An episiotomy is an incision made in the perineum. The perineum is the area between the vagina and the anus. It is made up of skin and muscle.

Reasons

An episiotomy is done to help some births. It will make the vaginal opening larger. An episiotomy may be done if:

  • The baby is:
    • Premature or otherwise fragile
    • Large and the shoulders may be hard to deliver
  • Forceps or a vacuum are needed to assist in the delivery

Episiotomy is no longer routinely done.

Risk

Some short-term problems may include:

  • Bleeding
  • Infection
  • Bruising
  • Swelling
  • Difficulty controlling your bowels

The risk of problems is higher with:

  • Severe scar tissue in the area
  • Prior problems with chronic pain in the vulva
  • Short perineum

Expect

Prior to procedure

Talk to your doctor about the benefits and risks of an episiotomy during a prenatal visit.

Anesthesia

Epidural anesthesia may already be in use for labor pain. This will numb your lower body. The doctor may use local or regional anesthesia. It will numb the the perineum and area around it.

Description of the procedure

The infant's head will start to stretch the vaginal opening. Special scissors will be used to make an incision in the perineum area. The incision will be closed with stitches after the baby is born.

Midline vs. Mediolateral Episiotomy

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How long will it take?

The process will only take a few minutes.

Will it hurt?

Anesthesia can block pain during the procedure. The area will have discomfort and swelling from birth and episiotomy. Pain medicine will help to manage pain.

Average hospital stay

The usual length of stay for vaginal delivery is 2 days. An episiotomy will not make the stay longer.

Postoperative care

It will take about 2 weeks for the cut to heal. It may be uncomfortable to walk or sit for up to 6 weeks.

Call

After arriving home, contact your doctor if any of the following occur:

  • Signs of infection, including fever and chills, swelling, redness, foul-smelling discharge
  • Pain that you cannot control with the medications you have been given
  • Bleeding from the episiotomy site
  • Continuing problems with loss of urinary or bowel control

If you think you have an emergency, call for emergency medical services right away.