Pronounced: ip-eez-ee-AWT-o-me
The perineum is the area between the vagina and the anus. It is made up of skin and muscle. An episiotomy is the cutting of the perineum.
The incision is made to make the vaginal opening larger during birth. It was once a common practice but is no longer routine. It may be needed if:
Some short-term complications may include:
Factors that may increase the risk of complications include:
During a prenatal visit, talk to your doctor about the benefits and risks of an episiotomy.
You may have local, epidural, or spinal anesthesia before the procedure. This usually depends on your wishes and what is appropriate to deliver your baby. After the baby is born, your doctor may give you local anesthesia before the incision is repaired.
The infant's head will start to stretch the vaginal opening. The doctor will then use special scissors to make a 1-3 inch cut in the area between the vagina and anus.
After delivery of the baby and placenta, your doctor will close the incision with absorbable stitches.
It is done quickly during childbirth.
If you receive local or spinal anesthesia, you will not feel pain during the procedure. After delivery, most women have discomfort and swelling. You may need to take pain medicine to help control pain while recovering.
The usual length of stay for vaginal delivery is two days. An episiotomy will not extend your stay.
Your stitches will dissolve in about ten days. The cut will heal within about two weeks. There may still be some soreness until the skin gets its natural strength back. This could take up to six weeks. During that time, you may find it uncomfortable to sit or walk. Ways to care for your perineum include:
After arriving home, contact your doctor if any of the following occurs:
RESOURCES:
American College of Nurse-Midwives
http://www.midwife.org/
American Congress of Obstetricians and Gynecologists
http://www.acog.com/publications/patient_education/
Women's Health.gov
http://www.4woman.gov/
CANADIAN RESOURCES:
The Society of Obstetricians and Gynaecologists of Canada (SOGC)
http://www.sogc.org/index_e.asp/
Women's Health Matters
http://www.womenshealthmatters.ca/index.cfm/
References:
American College of Obstetricians and Gynecologists. Rate of episiotomy plummets over past two decades. Medem website. Available at: http://www.medem.com/ . Accessed April 9, 2003.
Carroli G, Belizan J. Cochrane Pregnancy and Childbirth Group. Episiotomy for vaginal birth [systematic review]. Cochrane Database Syst Rev . 2000;(2):CD000081.
Episiotomy. Medline Plus Medical Encyclopedia. US National Library of Medicine and the National Institutes of Health website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/002920.htm . Accessed August 17, 2005.
Episiotomy: can you deliver a baby without one? Mayo Clinic website. Available at: http://www.mayoclinic.com/health/episiotomy/HO00064 . Updated June 2006. Access June 4, 2008.
Managing complications in pregnancy and childbirth: episiotomy. World Health Organization website. Available at: http://www.who.int/reproductive-health/impac/Procedures/Episiotomy_P71_P75.html . Accessed June 4, 2008.
Thorp JM, Yowell RK. The role of episiotomy in modern obstetrics. North Carolina Med J . 2000;61:118-119.
Last reviewed October 2009 by Ganson Purcell Jr., MD, FACOG, FACPE
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.