An Episiotomy is a surgical incision in the perineum (the area of skin between the vagina and the anus). It is the equivalent to a 2nd degree tear. Episiotomies are said to speed up the birth by up to 20 minutes.
What are some circumstances that would require an episiotomy?
An episiotomy may be needed for any one or more of the following reasons:
- Your baby is in distress
- You need a forcep assisted delivery
- Your baby is in a breech presentation and there is a complication during delivery
- There is a tear that is starting to go up into the peri-urethral area
How is an episiotomy performed?
If you have already had an epidural, you will probably not need any further anesthetic. Otherwise, a local anesthetic in your perineum, known as a pudendal block, may be necessary.
The mediolateral cut is angled down, away from the vagina and the perineum, into the muscle. The midline cut is performed by cutting straight down into the perineum, between the vagina and anus.
How can I prevent the need to have an episiotomy?
The following are preventive measures to lessen the chances of needing this surgical incision:
- Good nutrition (healthy skin stretches more easily!)
- Kegels (exercise for your pelvic floor muscles)
- Choose a provider with a low episiotomy rate
- Perineal Massage
- Optimal positioning during delivery
- A slowed second stage of labor where pushing is controlled
- Warm compresses and support during delivery
Can episiotomies be harmful?
The following are potential side effects of an episiotomy:
- Extended healing time
- Painful scar which may necessitate a period of abstinence from sexual intercourse.
What are some pain relief options for episiotomies and tears?
If you have an Episiotomy, or tearing, you may want to try some of the following to help ease the pain.
- Cold packs to the perineum. Ask your health care provider about special maxi pads that have cold packs built in.
- Take a sitz bath. Portable baths that you place over a toilet to let warm water cover the wound.
- Use medication such as Tucks.
- Use a personal lubricant, such as KY Jelly when you resume sexual intercourse.
- Wash with a squirt bottle instead of wiping after using the bathroom. Pat dry, instead of wiping can also help.
What if I want to avoid having an episitomy?
Clearly state on your pre-admit paperwork at the hospital, that you wish an episiotomy not be done unless absolutely necessary.
Reprinted with permission from American Pregnancy Association