Labor and delivery (18)
- Episiotomy: When it's needed, when it's not
- Signs of labor: Know what to expect
- Water breaking: Understand this sign of labor
- see all in Labor and delivery
Postpartum care (14)
- Exercise after pregnancy: How to get started
- Maternity leave: Tips for returning to work
- C-section recovery: What to expect
- see all in Postpartum care
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Episiotomy: When it's needed, when it's not
An episiotomy was once a routine part of childbirth. Today, the procedure is recommended only in certain cases. Here's what you need to know about episiotomy risks, benefits and recovery.
By Mayo Clinic staffAn episiotomy is an incision made in the perineum — the tissue between the vaginal opening and the anus — during childbirth. Although an episiotomy was once a routine part of childbirth, that's no longer the case.
If you're planning a vaginal delivery, here's what you need to know about episiotomy and childbirth.
The episiotomy tradition
For years, an episiotomy was thought to help prevent more extensive vaginal tears during childbirth — and heal better than a natural tear. The procedure was also thought to keep the bladder from drooping and the rectum from protruding into the vagina after childbirth.
Today, however, research suggests that routine episiotomies don't prevent these problems after all.
Recovery is uncomfortable, and sometimes the surgical incision is more extensive than a natural tear would have been. Infection is possible. For some women, an episiotomy causes pain during sex in the months after delivery. An extensive episiotomy might also contribute to fecal incontinence after childbirth.
The new approach
Routine episiotomies are no longer recommended. Still, the procedure is warranted in some cases.
Your health care provider might recommend an episiotomy if:
- Extensive vaginal tearing appears likely
- Your baby is in an abnormal position
- Your baby needs to be delivered quickly
If you need an episiotomy and you haven't had any type of anesthesia or the anesthesia has worn off, you'll likely receive an injection of a local anesthetic to numb the tissue. You shouldn't feel your health care provider making the incision or repairing it after delivery.
Next page(1 of 2)
- Robinson JN. Approach to episiotomy. http://www.uptodate.com/index. Accessed May 2, 2012.
- Toglia MR. Repair of episiotomy and perineal lacerations associated with childbirth. http://www.uptodate.com/index. Accessed May 2, 2012.
- Bharucha AE, et al. Obstetric trauma, pelvic floor injury and fecal incontinence: A population-based case-control study. The American Journal of Gastroenterology. In press. Accessed May 2, 2012.
- Sheikhan F, et al. Episiotomy pain relief: Use of lavender oil essence in primiparous Iranian women. Complementary Therapies in Clinical Practice. 2012;18:66.
- Lavender. Natural Medicines Comprehensive Database. http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs=MAYO&s=ND&pt=100&id=838&ds=&name=LAVENDER&lang=0&searchid=34422770. Accessed May 2, 2012.
- Aasheim V, et al. Perineal techniques during the second stage of labour for reducing perineal trauma. Cochrane Database of Systematic Reviews. http://summaries.cochrane.org/CD006672/perineal-techniques-during-the-second-stage-of-labour-for-reducing-perineal-trauma. Accessed May 2, 2012.
- Dame J, et al. Clinical inquiries: Does antepartum perineal massage reduce intrapartum lacerations? The Journal of Family Practice. 2008;57:480.
- Lowdermilk DL, et al. Maternity & Women's Health Care. 10th ed. St. Louis, Mo.: Elsevier Mosby; 2012:470.
- You and Your Baby: Prenatal Care, Labor and Delivery, and Postpartum Care. Washington, D.C.: The American College of Obstetricians and Gynecologists; 2011:35.
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