Episiotomy
Definition
Episiotomy is a procedure in which the skin between the vagina and anus is cut. (This area is called the perineum.) Episiotomy is done occasionally to enlarge the vaginal opening so that a baby can be more easily delivered.
Description
Just before the baby is born, the obstetrician numbs the vaginal area opening and makes one of two cuts:
- A mediolateral cut is angled down away from the vagina and into the muscle.
- A midline cut is made straight down between the vagina and anus.
The cut makes the opening to the vagina bigger. The cut is stitched closed after the baby and placenta have been delivered.
Risks
Many studies have found that the procedure offers no benefit in routine deliveries, and there is no evidence to suggest that it improves a woman's sexual function. It has also been found that women who have an episiotomy have more intercourse-related pain after pregnancy and take longer to resume having sex after childbirth.
If an episiotomy cut is made, there is more of a chance that it will become a larger tear or even extend into the muscles around the rectum. This can lead to later problems with controlling gas and sometimes stool. When no episiotomy is made and a woman is just allowed to tear, these problems are less likely to happen.
Additional risks include:
- Bleeding
- Bruising
- Incontinence
- Infection
- Swelling
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
