Has Your Doctor Mentioned an Episiotomy?

Posted by Kathryn Wilcox on August 03, 2015

Are you worried that your “natural vaginal delivery” may be complicated by something called an episiotomy mentioned by your doctor in your last visit? This medical procedure used to be a routine part of childbirth in the 50’s and 60’s.

A surgical incision made in the muscle between the vaginal opening and the anus and was believed by doctors to be a good way to prevent tearing of tissue during delivery. It was also thought to heal better since it was a clean cut rather than several irregular tears in the area.  Some physicians also felt that it kept the bladder and rectum from pushing down into the vagina after delivery.

Years of research and tracking has revealed that a routine episiotomy actually did not prevent the problems that the doctors were trying to avoid with the procedure. It was also unpopular with women because it caused a painful recovery and was often more extensive that a tear would have been. Some also had complications from the incision including infection, painful intercourse and even fecal incontinence.

Even though this procedure is no longer considered routine and not recommended by the majority of obstetricians and gynecologists, there were still as many as 400,000 performed in 2009, a surprising 35% of all deliveries. It is very important that you discuss this with your doctor.

There are some legitimate reasons for this procedure. You do need to trust that your doctor may recommended that it be done if it appears you will have extensive tearing from a very large baby, or if your newborn is in an abnormal position.  Another reason would be if there is a medical reason for the baby to be delivered quickly, such as stress on the baby’s heart during labor.

If it is necessary for the procedure to be done, your doctor will administer a local anesthetic to numb the area so you should not feel the incision being cut or repaired after delivery. You will also be given instructions for sterile aftercare to prevent infection of the wound.
The most imperative thing to do is to discuss this with your doctor so that you understand this procedure and are comfortable with the reasons why it may be used in your own situation. Your health and your baby’s well-being are the most essential consideration and should be the criteria used in making this decision.