What is an episiotomy and when it is necessary?

An episiotomy is a surgical incision that is sometimes necessary to enlarge the vaginal opening to help deliver your baby. There are several reasons your health care provider might suggest an episiotomy to you:

  • If your baby’s head is too large for your vaginal opening

  • If you need a forceps assisted delivery

  • If your baby is breech presentation

  • If your baby is in distress, and they are trying to hurry up the delivery


Whether you need an episiotomy will depend on the amount of tissue in your perineum, the size of the baby and your care giver’s judgement on whether you are going to tear. Tears are much more difficult to heal than clean edged cuts. The perineal tissue can be stretched using massage and mineral oil as you are pushing. The baby’s head will stretch the perineum also. It is estimated that about 50% of women will need an episiotomy.

There is however, a newly published study on the benefits of episiotomies. This study reports that episiotomies might make the very complications they are supposed to prevent much more likely.  They also reported higher incidence of pain and other side effects of the episiotomy during the recovery period.

During the last trimester of your pregnancy, be sure to discuss their view on episiotomies and let him know your questions.  Ask what steps you can take to reduce your risk factors for needing an episiotomy or tearing.

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