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Episiotomy

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What is it?
An episiotomy is an incision made into the perineum (the space between the vagina and the rectum) to enlarge the vaginal opening.  Incisions are typically either midline (down toward the rectum) or mediolateral (a little to the side of the rectum).

Why do I need it?
An episiotomy is made to hasten the delivery of the baby.  It is important to talk to your doctor regarding their use of episiotomies.  Some doctors do them routinely, and some doctors try to avoid them.  Some doctors believe that an episiotomy incision is easier to repair than a natural tear; however, others believe that most tears are not as severe as an incision so they are easier to repair and heal. 

How does it feel?
Typically women do not feel the cut of an episiotomy because the baby's head is pushed against your perineum and other feeling is reduced.  However most doctors give women a local anesthetic to be sure they don't feel it as well as to numb the area for the repair.  After birth is finished an you are recovering, an episiotomy can be quite painful.  Urination and bowel movements can be uncomfortable for a few weeks.

How will it affect my baby?
Babies are not typically affected by an episiotomy, but you may not be able to hold your baby while the doctor is repairing the incision.

What are my other options?
The alternative to an episiotomy is letting the perineum tear naturally.  This tear can be smaller and less severe than an episiotomy, or the tear can be just as large as an episiotomy.  Each mother is individual in this aspect and each birth for a mother can be different from the past.

How soon must I make a decision?

This is individual to each mother and each doctor, but it is a valuable question to ask.  You may also ask if you can try changing positions before this method is attempted.  It is important to talk with your doctor before the birth to be sure they know your preference.