How many women need episiotomy

If you don't want to have an episiotomy--and who does? Preventive measures. Studies show that perineal massage can reduce the need for an episiotomy. Massage can help make the perineum more flexible and stretchy, so when the baby comes out, the perineum is more likely to stretch than tear. To do perineal massage, sit in a warm bath and gently massage the area around the opening of the vagina for about 10 minutes a day, beginning around week This won't guarantee you an episiotomy-free or tear-free delivery, but it may help.

When an episiotomy is required. Episiotomies may be necessary in some situations: if your baby's heart rate drops and delivery is expedited by cutting the perineum, if she is being delivered by forceps or vacuum suction, or if her shoulders are too wide to fit through the birth canal. The procedure. If you have an episiotomy, your doctor will give you a shot of local anesthetic to numb the area before cutting, unless the area is already numb from your epidural.

The cuts range from superficial to deep: An episiotomy is said to be first-degree if only the skin is cut; second-degree if the skin and underlying tissue are cut; third-degree if skin, underlying tissue, and the muscle around the anus are cut; and fourth-degree if the cut goes through the rectal mucosa as well as the other three layers. Usually only a second-degree cut is made, but the baby's head extends the cut to tear the muscle or rectum.

After your baby is born, your doctor will stitch the episiotomy and other tears with dissolvable sutures. All content on this Web site, including medical opinion and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation.

Use of this site and the information contained herein does not create a doctor-patient relationship. An episiotomy is an incision made in the perineum — the tissue between the vaginal opening and the anus — during childbirth. Although the procedure 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. 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 help preserve the muscular and connective tissue support of the pelvic floor. Today, however, research suggests that routine episiotomies don't prevent these problems after all.

A midline median incision shown at left is done vertically. A mediolateral incision shown at right is done at an angle. A midline incision is easier to repair, but it has a higher risk of extending into the anal area. A mediolateral incision offers the best protection from an extended tear affecting the anal area, but it is often more painful and is more difficult to repair.

Routine episiotomies are no longer recommended. Still, the procedure is sometimes needed. Your health care provider might recommend an episiotomy if your baby needs to be quickly delivered because:. 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 the episiotomy, but recovery can be uncomfortable. Your healthcare provider will discuss different techniques for improving your comfort as you heal. Episiotomy 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. A midline episiotomy puts you at risk of fourth-degree vaginal tearing, which extends through the anal sphincter and into the mucous membrane that lines the rectum.

Fecal incontinence is a possible complication. Any stitches used to repair the episiotomy are usually absorbed on their own. You might take prescription medications or use an over-the-counter pain reliever or stool softener.

However, pain-relieving creams or ointments haven't been found to be effective for episiotomy wounds. While you're healing, expect the discomfort to progressively improve.

Contact your health care provider if the pain intensifies, you develop a fever or the wound produces a pus-like discharge. These could be signs and symptoms of an infection. Talk to your midwife or GP about which activities you should avoid during the healing period.

Read more in our article on episiotomy recovery. You can then get treatment if required. Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: You might find attending one of our Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby. You can find out more about the types of tears that can occur during childbirth, how to minimise your risk of deeper tearing, and what can be done to help your recovery if you do tear. It also covers what to do if you have any concerns about your recovery, helping you feel better informed when discussing any topics with a healthcare professional.

Beckmann M, Stock O. Cochrane Database Syst Rev. Frolich J, Kettle C. BMJ Clin Evid. NHS Choices. When it comes to content, our aim is simple: every parent should have access to information they can trust.

All of our articles have been thoroughly researched and are based on the latest evidence from reputable and robust sources. We create our articles with NCT antenatal teachers, postnatal leaders and breastfeeding counsellors, as well as academics and representatives from relevant organisations and charities.

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