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All your pregnancy questions answered

Episiotomy

• What is an episiotomy?

"..is an incision into the perineum (Area of skin between the vagina and the anus) to enlarge the space at the outlet."

• What are the benefits of an episiotomy?

Episiotomies are said to provide the following benefits:

1. Speed up the delivery

2. Prevent irregular tears

3. Prevent urinary incontinence [leak] at a later age

4. Is easier to repair and heals better than an irregular tear

5. Prevents vaginal laxity later in life

• The types of episiotomies

You may be given a midline episiotomy which extends straight back from the rear of the vagina towards the rectum, or more commonly you may be given a medio-lateral episiotomy which curves away from the rectal area. The two types are shown below:

• The controversy about episiotomies

There is disagreement in the medical community over the value of or need for episiotomies and many obstetricians no longer use them routinely.

Some health professionals believe that episiotomies:

- Heal faster and have less risk of infection than a ragged perineal tear.
 -Can prevent a larger tear or injury to the muscles around the vagina and rectum.
 -Can shorten the pushing stage of labor (second stage of labor).

Other health professionals believe that episiotomies:

-Are often not needed.
-Do not necessarily heal faster than a perineal tear, and may cause more pain.
-Can cause more damage to the muscles around the vagina and rectum than a tear.

The decision to have an episiotomy probably cannot be made until delivery. If an episiotomy is determined by your health professional to be necessary, it should only be done just before delivery. You may want to discuss this issue with your health professional at one of your prenatal visits.