Everything You Need To Know About Episiotomies

Up until the last decade, episiotomies were considered a routine procedure and performed on the majority of women giving birth vaginally. Today, episiotomies are no longer considered routine, but the frequency of how often they are performed still varies widely amongst hospitals. Some hospitals resort to episiotomies in less than 1% of vaginal births, whereas others use it in 40% of their vaginal births. Since this practice is still being used in instances where it is not necessary, It’s important for expecting mothers to know the true facts about episiotomies, their potential effects, and in what cases it might actually be needed, so they can make their decision with confidence.

What Is An Episiotomy?

An episiotomy is an incision that is made through the perineal skin and muscles, extending from the bottom of the vagina towards the anus. It is done for the purpose of enlarging the vaginal opening to make more room for the baby to come out, rather than taking the chance of tearing naturally.

Episiotomy Myths and Realities

For a long time, episiotomies were a routine procedure because it was believed that an incision would heal easier and better than a tear would. It was also something that could be controlled, so the assumption was that the incision might be smaller or less damaging to pelvic floor muscles than a tear would be. Evidence has shown that this is not the case. Episiotomies actually increase the chances that you will have a more severe tear that extends down into the rectum. Natural tears are also oftentimes less extensive, not as deep, and heal much easier and faster than an incision. Your perineum, which is the area between your vagina and anus is designed to be able to stretch to accommodate your baby coming out. Your pregnancy hormones are already working to help the area to soften and expand, but there are other things you can do to help, such as drinking raspberry leaf tea in the weeks leading up to your due date, using warm compresses, perineal counterpressure, and avoiding intense, forced pushing in labor.

When Might You Need An Episiotomy?

There are still some instances where you may need an episiotomy, but usually these are reserved for emergencies. Examples of instances where an episiotomy may be necessary to ensure that your baby can get out safely and quickly to receive help are: if your baby’s shoulder is stuck behind your pelvic bone or if your baby is in a serious case of fetal distress. Ultimately, episiotomies should be used as a last resort.

An episiotomy is a surgical procedure and consent does need to be obtained before it is given. Unfortunately there is an extensive, horrifying history of practitioners giving episiotomies either without asking or even after being told no so make sure your provider is telling you everything they might need to do to you before they do it and always asks for your consent.