Episiotomy: Discussion

Can you explain about an episiotomy?

The perineum is the area between the rectum and the vagina. During delivery of the baby this area undergoes a huge stretching process, which sometimes results in tearing. Your doctor may make a cut during the delivery in order to prevent the tearing that takes place. This is called an episiotomy.

Generally the episiotomy will either be made in a straight line between vagina and rectum. However, due to the very slight risk of the cut opening up right into the rectum, the cut can also be made at an angle.

Performance of the episiotomy is another area of ongoing debate. There are doctors who are certain that cutting is preferable to tearing, that the cut will generally be smaller than any tear which would occur later, and that by cutting they are reducing the pressure on the head of the baby. However, the doctors who allow tearing are equally sure that tearing will occur along natural weaknesses in the perineum and that limits the damage, which in turn heals quicker. Current research does not seem to indicate that cutting is preferable. It may be useful to you to establish your doctor’s ideas on episiotomy so that you have some idea of what he will do should the situation arise. But either way, there are situations which do call for an episiotomy, such as a forceps or vacuum delivery, a very large baby and a delivery where the baby is shoulder first. You must trust your doctor to make the appropriate decision should the necessity arise.