Episiotomy

How is an episiotomy performed?

During the delivery of a baby, some women will require an episiotomy. An episiotomy occurs when the doctor takes a sterile pair of scissors and makes an incision in the tissue between the vagina and anus (the perineum).

Having an episiotomy was once considered to be a routine part of childbirth because doctors thought that a woman would heal faster from being cut than tearing naturally. With research and testing, doctors have now found that an episiotomy does not usually offer any great benefits. However, there are times that an episiotomy is still necessary during childbirth. Doctors will perform an episiotomy to make the vaginal opening larger if your baby needs to be delivered quickly. Doing so could prevent your baby from being stuck in the birth canal and suffering from oxygen deprivation. Your doctor may also perform an episiotomy if he feels that your vaginal tissues will tear extensively. A large vaginal tear may be more painful and take longer to heal than a simple episiotomy in this case.

An episiotomy is done in your labor/delivery room and is performed by your doctor. Your obstetrician will use a sterile pair of scissors to careful snip the perineum. If you have not had an epidural or pain medications, you will receive a local anestethic to numb the area to be cut. However, because of the pressure of the baby's head, you will not feel the cut anyways.

You can help soften the tissues in the vagina and perineum during the last few weeks of pregnancy by having perineal massage. Although the massage will not guarantee against tearing or needing an episiotomy, it may help to reduce the chances. You simply wash your hands well with soap and water. Using a lubricant, place your thumbs inside of the vagina and rub downwards towards the rectum. You should do this for 5-10 minutes each day. Your spouse or labor partner can help with the massage as well.

Healing from a vaginal tear or episiotomy takes some time. The perineum will be very sore for a few days to a few weeks after delivery, depending on the severity. Episiotomies generally hurt worse when you are sitting, walking or using the bathroom. It is critical that you keep the episiotomy site clean. Most hospitals will give you a squirt bottle to use for this purpose. Use an ice pack, witch hazel pads or a wound spray to help soothe the area. Take pain medications if needed and prescribed by your doctor. Be aware that when you are urinating, it may burn. Some women find that squirting warm water on their vagina while they are urinating helps to ease the burning sensation. Finally, take your time. Sit down carefully and walk slowly. Call your doctor if the wound becomes extremely painful, red, hot, swollen or has a foul odor or discharge.

Comments: Episiotomy

Comments 1 to 17 of about 17.
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maryelainas - 85 days ago.
I had an episiotomy on my first. I was a little upset because I felt like I shouldn't have needed it. It healed just fine though. I was totally back to normal probably around 4 weeks but I was too nervous to do anything until the 6 week check-up. The doctor said it was fine. It is totally back to normal. I don't even notice a difference. And I haven't had any complaints from DH about sex. I hope that this next pregnancy I won't need it again!!!

GoRejiss - 286 days ago.
I just had my first baby a few days ago (august 6th) I had to get an episiotomy and I'm still healing. I was wondering if they stitch u all the way up to how ur vagina was before? And if not, will it close up and heal back to normal. I looked down there with a mirror to see if I could tell but I didn't wanna spread anything. I rlly hope they stitched me up to how my vagina was before. Another question, after having one episiotomy does sex feel the same? And can u see the scar?

hismommie11 - 624 days ago.
OMG! im so scared that i will have this! my baby is expected to be 10lbs at birth and he has a HUGE head! omg so scared

bandrsmum11 - 730 days ago.
i had to have an episiotomy with my now 4 month old son. I have an older son who is 9years old who was 9lb 4 oz at birth i tore quite badly with him and also had open grazes aswell as needing stitches. Afetr a 9 year gap between pregnancies i was very scared of neeing stitches agan this time as recovery time was a long slow process :-( This time around due to my sons position he was delivered in theatre by forceps so i had to have an episotomy. I had had a spinal block so could not feel a thing ( which im so glad about). I was abit disapointed to be cut BUT healing time this time was so fast all healed nice neat (now brely visable) scar and had no problems at all. So for me I would take episiotomy over tearing anyday as i have experienced both and can definetly say being cut was far better for me .

star69elvis - 901 days ago.
I wanted to ask if anyone has ever used or known someone who used an Epi-Stop? Its a... well, like a balloon thing for your vagina (that sounds soooo wrong...), that you use for the last two weeks before giving birth, which helps to expand your perineum, and its supposed to reduce the need for an episiotomy. I am very keen to avoid episiotomy, so wondered if this might be worth a go? Or did anyone try try the perineum massaging technique? I am currently 20 weeks and doing my birth plan research... :) - any info, please can you comment to my profile page? Thank you ...

anxiousmami - 905 days ago.
Man, why did I go to this topic I'm due in 11 days. :( anywho w/ my DD I didn't get an episiotomy I tore only I tore up into my vagina instead of down. I felt that rip and they literally had to sew my vagina back into a vagina. It healed quicker than it wouldve if I tore down from what I was told. I would get the oddest sensations too from it for over a year it seemed. Like if I got cold or something. Everythings good now. But crap am I scared this time!! I was told that if it was very forceful pushing then that may have been the cause. Which from what I remember it was, I pushed and let out a horror movie yelp and baby shot out. :/

tjb - 977 days ago.
I had an episiotomy w/ my first child 10 yrs ago...but luckily have never had to have one w/ my 2 little girls and hoping not this time around either!!It is definitely not a fun recovery!!

janinem - 1048 days ago.
I had an episiotomy with the birth of my ds. He was facing up instead of down so the angle of his head made it very difficult for him to come out without help. They had to use a vacuum too. And yes, they definitely numb it first. The recovery is not fun. It's very painful to sit, shower, pee, sleep etc. I had a lot of warm baths with epsom salts and used a peri-bottle whenever I went to the bathroom. I also used cold tea bags in my pads. I took lots of Tylenol and Advil. I'm hoping I don't need one with my next baby. And I am definitely demanding an epidural next time! It's been 15 months since ds was born and everything is pretty much back to normal down there. Sex is great! We were back at it after 6-7 weeks. Thank goodness because I was so worried it would never be the same.

ethans-1st-time-mommy - 1048 days ago.
Question: I tore pretty bad & had stitches; needless to say I'm not the same down there. Will I ever get used to it the way it is now? I can feel the difference when I move sometimes. Plus I'm afraid to have sex again because I'm worried about retearing.

motomumma - 1060 days ago.
Has anyone had a vaginal reconstruction? I had a natural birth and tore a little bit, the tearing definitely hurt the most, but only lasted the few seconds it happened then the healing was fine. However, the midwife went to get a Dr from the hospital to stitch me up and as there was none she took a second look and said I didn't need stitches. This has proved to be terrible as it has not felt the same when I am with my partner. Another midwife told me 'many women have vaginal reconstructions when they finish having their babies'. How long do I have to wait? It has been 3 years and I am now pregnant again, can I have stitches after this pregnancy even if I don't tear? Can you stitch up something that has healed over? The words 'vaginal reconstruction' terrify me!

littlemurph - 1096 days ago.
not sure if anyone has had this problem before, but i went for my 6 weeks check up and my episiotomy had not healed..it was painful and sore still. so the doctor told me the stiches has dissolved but the cut never closed, put bacitracin, keep the area clean and come back in 4 weeks. so i went back yesterday and he said that it closed but a piece of the fleshy part of the cut was pushed out and closed under...i guess like a skin tag? so there's a fleshy piece out, and not healed. he said over time it might die off and fall off...but he wants to do a local anesthetic and cut it off!! can't fathom the thought of cutting it!! so i pushed it off for another month! HELP, anyone have any advice or had this happen to them!!!???

uklizzie - 1111 days ago.
Eww I had an episiotomy as I was struggling to get my baby out, they cut all the way. Did'nt feel a thing at the time as I had, had an epidural so didn't feel them stitch me up either....but when it wore off boy I was in pain!! I couldn't sit down for 3wks I had to lie down. I used to bath twice a day as it soothed it, it was so swollen and bruised down there, the midwife said it looked like I'd been kicked by a horses hoof!!! Full recovery was about 12mths. we had sex after 4mths but it was uncomfortable. All back to normal now. I think a cut is better than a tear as apparently a tear is really hard to stitch back up properly, where as I straight cut goes back together easier. I don't know whats better really, an episiotomy or a c-section?? I am pregas again now with twins.....so we will see whats in store for me labour wise this time!!!!!!! Good luck ladies x

KyMMie MuMMy - 1166 days ago.
I'm pregnant with my third baby. My daughter and son both weighed 5 pounds (her 12 ounces/him 13 ounces) no tearing, just grazing. I am so terrified of tearing or having an episiotomy. It looks and sounds scary. Do they numb you to put the stitches in?

RainBowBaby 5 - 1166 days ago.
when i was pregnant with my first daughter she weighed 9lbs and i needed help getting her out..so he used the scissors and then i pushed her out..after the doc stitched me up i went to sleep and they wanted me to go to the bathroom.OH MY GOD THE PAIN!!!! with my 2nd daughter she tore me badly...

*AMANDA* - 1472 days ago.
my daughter is now 18 months, and she came out 'sunny side up' and i got a pretty bad episiotomy. sometimes it still hurts. like if me and hubby are together and he puts too much verticle pressure down there it really hurts. it makes me sad that im thinking it will never be the same again...

kayp - 1608 days ago.
I dont think it matters the size of the baby. My boy was 5 lbs 15 oz and I tore on both sides and had stiches. I healed just fine, but of course it was uncomfortable to deal with. A friend of mine learned something in nursing school. They said they don't like giving episiotomies b/c it cause you to tear. Picture a piece of paper and try to tear it softly, then cut it with schissors and it tears right down. Guess thats why my doc didn't give me one...

waiting4boy3 - 1609 days ago.
I had an episiotomy with my first son who weight 9lb 7oz. It was the worst part of labour. I couldn't sit down for weeks. The only relief I got was from taking epson salt baths. With my second son the doc said I wouldn't need an episiotomy because the baby wasn't going to be as big. Well he was bigger 9lb 14oz and I tore. It was nasty. It took much longer to heal than the episiotomy and it looked so gross. I am almost due with my third boy and I'm scared. Should I ask for an episotomy so I don't tear? I've heard about perineum massage but when I asked the doc he said it doesn't work.