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What Is an Episiotomy?

A friend of mine needed an episiotomy when she gave birth. Can you explain what this is?

Re: A friend of mine needed an episiotomy when she gave birth. Can you explain what this is?

The Bump Expert

An episiotomy is an incision in the perineum (the skin between the vagina and anus) that helps baby fit through. Doctors used to routinely perform episiotomies because a surgical cut was thought to prevent tearing. But, it's now known that episiotomies don't prevent tears, and that natural tears actually tend to heal better than episiotomies. However, doctors will still perform an episiotomy in certain situations, such as to help deliver baby more quickly when there are signs of fetal distress.

If your doctor does decide you need an episiotomy, you'll receive a local anesthetic (unless your perineum is already numb from the pressure of baby's head). Once baby is safely delivered, your doc will give you another shot of local anesthesia and stitch up the cut. After a few weeks, the stitches (and your memory of this icky part of childbirth) will disintegrate.

watch: more about episiotomies

re: Q: What is an episiotomy?

I wonder if this info is accurate b/c my Dr told me exactly the opposite. He said that tears are harder to stich up b/c they are not a clean cut

karukaru |

re: Q: What is an episiotomy?

I went to my doctor a few weeks ago saying I wanted an episiotomy & did not want to tear. I had one with my first & it was fine for me. I heard the same about the stitching being easier. This time though they are against it & said if they cut & then say the elbow comes out with the head or she is turned a weird way it could make it so I tear to the 4th degree which would be to my rectum & that can cause serious problems. So I have changed my mind.

EJAYDE5801 |

re: Q: What is an episiotomy?

Tears are harder to stitch, but heal better (less painful healing and less problems long term). Another thing to keep in mind is the analogy of cloth ripping. If you take a piece of cloth and try and rip it, it is hard to do, but if you put a nick in it or start cutting it, then try and rip, it becomes much easier. Not to say that all episiotomies lead to tears, sometimes episiotomies have their place, just that sometimes they can make what would be a small tear a very bad tear.

DerdsGirl |

In my childbirth classes, they said that natural tearing is better and your healing process will be faster. In addition, mistakes can be made with the episiotomy, causing problems in the rectal area.

Constant2001 |

There is no reason to voluntarily have an episiotomy. It is not natural and the cloth ripping analogy is so true, once cut, you will just rip easier. You also have a higher risk of infection and you may not heal correctly. Let your baby be born naturally and tell that doctor NO. I am absolutely not having an episiotomy.

shaymichelle89 |

Well, I just delivered Saturday night and I have to say, when my daughter's head was out and the cord was around her neck and the shoulders were stuck, they didn't even ask me (nor did I care)---they just cut. At that point I didn't even realize what they were doing. I would never ask for a cut just because---but trust me...if you really do NEED one (like I did) you will just be happy that your child was born okay. My daughter is beautiful and eventually I'll heal up just fine.

carouselgirl73 |

I actually had to have 2 episiotomies during my first delivery. It took me just over 2 hours to push her out, and I was so tired when the MD told me she was going to "cut" me, I said "just do what you have to do". Fairly uncomfortable recovery, I'm hoping not to need one with my second child!

AllieK05 |

I was adamant I did not want an episiotomy. While I was pushing before I delivered my daughter my nurse warned me I was going to tear. I told her that was fine. My doctor honored my wishes. I had a level 3 tear. My doctor stitched me up. It was swollen and soar for about a week. By week two I was 95+% feeling back to normal down there. My daughter is now 3 months and I'd never know that I'd torn. All my friends that have had episiotomies have had pain and discomfort for as long as a year+. Every birth is different, there are always medical issues that may justify an episiotomy... but if you don't have to get one just let nature take its course.

tansytat |

I visited the chiropractor the other day and she recommended to start moisturizing "down there" and even inside some what with an oil so to help with stretching so that I wouldn't tear. Any thoughts on this recommendation? I haven't heard of it any where else.

katiebabe5 |

Oil may help. My mom has 7 kids, she is very small. Had them all at home, no tearing whatsoever, her Doctor constantly stretching used olive oil during labor. I am due in 10 days and am bringing the oil with me in a small container to have someone do while I am in labor, if you can't get your labor nurse to do it - see if you can get someone else to help. My mom has delivered dozens of babies so I am fortunate to have her help. This is my 2nd, didn't rip at all with the 1st. I think a lot is genetics too. Good luck!

krobinsd |

can you feel or hear the ripping sound when you tear....and now hearing about episiotomy makes me want to just let nature take its course

trinity16 |

Hi gang! With my first born I did not elect for an episiotomy based on more current guidance that tearing is better than cutting. Since he was 9.6 lbs, I tore and I had a horrible time healing. I think it was mostly because of the way in which I tore. I have no idea if getting cut would have provided a cleaner cut for them to have stitched but it makes me wonder?? I'm 38 weeks pregnant with my second and am just praying that my first son 'paved the way'...LOL...for the next one as they're projecting him to be just as big. All in all, I think it's a crap-shoot. There's no right way and each case is different. The one thing I will say is LOOK INTO PERINEAL MASSAGE. It is where you massage the area between the vagina and the rectum and yes, olive oil works well for this. It's kind of hard to do on yourself so have fun with it with your spouse or find a midwife or doula that can do it for you but you want to START AT 35 WEEKS...don't wait until delivery. Here is a good site to look at for this process: http://www.pregnancy.org/article/perineal-massage. Good luck to each of you. Do you research & find what will work best for you as an individual!

carriegq |

i had to have an episiotomy because my daughter got stuck, i had an epidural so didnt need a local but it caused alot of problems for me, the muscle u have between the vagina n bum had completely severed n was left with one gapin hole, i had to have emergency surgery n a blood transfusion, if it can be avoided, i wouldnt recommend them, its better to tear naturally n will heal much better n quicker

moonwalker84 |

I had a level 4 tear with my first (8 pounds 8 ounces) whose arm came out with his 14 1/2 inch head. I had an episiotomy with #2 (8 pounds 3 ounces) but tore anyway with his 14 inch head. I am 37 weeks preggo with #3 and he is already measuring nearly 10 pounds by ultrasound and we are looking at a c-section, but if I do end up delivering vaginally I will ask for an episiotomy knowing how big he already is and dealing with scar tissue already on 4 levels. I totally trust my doc and will leave it up to her.

nothingwithoutjesus |

I am a short woman, only 5'1", and with my first child i said only do an episiotomy if it was needed. my doctor did not perform one. In the end I tore just a little, took only 20 minutes to push my son out, and he was an 8 pounds 7.2 ounce baby, and his head and length were in the 90 percentile (omg huge head aaacck!!). I ended up with three tiny stitches. I would say to any woman doing a vaginal birth to just try to not be afraid of tearing. it sounds horrifying I know but three small stitches are MUCH BETTER than a long cut in your body. Just try to relax and not be afraid, in the end your tear might not be so bad. that being said, i am 38 weeks along with baby number 2, also a boy, and I hope things go as well as they did with the first one.

dejahdonut |

my first child I was cut and still ripped to a fourth degree,and My son was 8# 12 oz with very broad shoulders even if i was not cut i still would have torn I did not know that i tore nor could i feel it with all that was going on with delivering and the joy of a haveing my little guy in my arms. i think it is a personal choice, im getting it done again just to have a clean tear hopefully not a fourth degree again but my body will heal and so will everyone elses just rember that no matter how bad it hurts or sounds the birth of a happy healthy child makes it all worth it best of luck to all ...i`ll be Induced in 7 days with # 2 :)

alwrube |

Prevention is key. Do you kegal exercises and get off you back. Doctors may want you to deliver your baby on your back but that is the worst position. You will have an easier time delivering your baby squatting or getting on your hands and knees. Do your research.

pchefshawna |

I too was cut during my first delivery. I wish I had been more adamant about not wanting an episiotomy. The scar was painful over a year later. Luckily my mom is a physical therapist and suggested I go to a women's health PT. They deal with things like incontinence but also painful episiotomy scars. After a few visits it was much better. So many women don't even know about this option, but you should not be having pain a year after you give birth. I'm now due with my second and I think I'll take my chances with a natural tear...

BabyV1009 |

I had a 2nd degree episiotomy with my son. He was just under 9 lbs and had shoulder dystocia. It was the one thing that my OB and I had discussed and I was against. However, at the time, I asked, "Is it medically necessary." And he said that yes, my son was in distress and needed out NOW. I agreed. I was honestly to afraid to touch it for several days, fearing the worst. By the time I did (still less than a week later), the stitches had mostly dissolved and it didn't bother me at all. Yes, it was tender to sit down for a week or so, but that's the case with any baby, not just if you tear or get cut. While I hope not to need one this time around (getting induced in 6 days!), if it's necessary again, I will agree again. I still would prefer that to a tear. And as a totally different bonus, I felt like it "tightened me up" a little bit down there, instead of being stretched out after childbirth :)

ponygirlatcua |

We did the massage, I still tore & had an episiotomy. You won't know until you get to that point how your body will respond.

Aprl2013 |

With my first, I tore and needed only 7 stitches. Tearing is a natural occurrance and I healed within a week and a half. Having an episiodomy takes longer to heal, alsothe Doc. may cut more then he needs. Doctors are quick to do and say things, to make their jobs more exciting and challenging. Watch "The business of Being Born". Interventions is what Docs are all about. If your body was meant to tear during childbirth, let it happen, because it is natural. That is my opinion.

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