Home > Health Library > Episiotomy and Perineal Tears
An episiotomy (say
"eh-pih-zee-AH-tuh-mee") is a cut the doctor or midwife makes in the
perineum (say "pair-uh-NEE-um"), which is the area
vagina and anus. It is done to help deliver the baby
or to help prevent the muscles and skin from tearing.
The cut is
made just before the baby's head comes out of the birth canal. It is stitched
up after the birth.
There are times when
an episiotomy is needed—for example, if the baby's heart rate drops too much during
pushing or if the baby's position is causing problems. The decision cannot be
made until delivery. Episiotomies are more common with first-time deliveries.
Routine episiotomy is not recommended.
Experts say that episiotomy:1
In the past, episiotomy was a very common part of
childbirth. Many doctors no longer do episiotomies routinely. But a few still
do. If you have a concern about this, talk to your doctor or midwife ahead of
It's not uncommon
for the perineum to tear during birth. But there are steps you can take to help
prevent this:1, 2
If you had an incision (episiotomy) or
a tear in the area between your vagina and anus (perineum)
during delivery, your doctor or nurse-midwife will repair it with stitches,
local anesthetic. An ice pack will be placed against
your perineum to ease pain and swelling.
Recovery from an episiotomy or tear can be uncomfortable or quite
painful, depending on how deep and long the incision or tear is. Pain typically
affects sitting, walking, urinating, and bowel movements for at least a week.
Your first bowel movement may be quite painful. An episiotomy or tear is
usually healed in about 4 to 6 weeks.
To reduce pain and promote healing:
Agency for Healthcare Research and Quality (2005). The Use of Episiotomy in Obstetrical Care: A Systematic Review. Evidence Report/Technology Assessment No. 112. Available online: http://www.ahrq.gov.
Beckmann MM, Garrett AJ (2006). Antenatal perineal massage for reducing perineal trauma. Cochrane Database of Systematic Reviews (1).
Other Works Consulted
American College of Obstetricians and Gynecologists (2006, reaffirmed 2008). Episiotomy. ACOG Practice Bulletin No. 71. Obstetrics and Gynecology, 107(4): 957–962.
Kettle C, Tohill S (2008). Perineal care, search date April 2007. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
November 2, 2011
Sarah Marshall, MD - Family Medicine & Kirtly Jones, MD - Obstetrics and Gynecology
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