For the most part, your body will know exactly what to do when the time comes to deliver. While you might be worried during your pregnancy about things going smoothly, you’ll probably be impressed at your body’s ability to stretch, repair, and heal itself during and after labor. Unfortunately, there are some instances when your body cannot handle a certain condition and it might need a bit of medical assistance to help labor along. One such method of assistance is an episiotomy.

An episiotomy is a procedure performed by your obstetrician that creates an incision between the rectum and vagina. The incision opens the vagina more so that the baby can fit through more easily. You will only need an episiotomy if your doctor thinks that you are at risk for a vaginal tear during childbirth, or if your delivery is going slowly and your baby seems to be negatively affected. If your baby’s heart rate decreases during labor, your doctor might recommend the procedure because labor will be over much more quickly after the incision is made, and your baby will be in the care of the nursing staff. An episiotomy might also be recommended if your baby is in the breech position when you start going to into labor. Breech births are more difficult because the baby has a harder time fitting trough the birth canal, so an incision would make sense.

If you don’t receive in episiotomy and you get a vaginal tear, it will take longer to heal than the incision made by your obstetrician. Since doctors can plan the cut, it will be cleaner and shallow.

However, there are also risks associated with getting an episiotomy, so you should only get one if your doctor deems it necessary. You’ll have a higher risk for infection after getting the incision, and childbirth will hurt more than if you had no tearing at all. It will take you longer to heal after you’ve given birth, and intercourse will be painful until the incision has completely healed. When you’re a new mom trying to get back into the swing of your life, this healing time can be arduous.

Some women need an episiotomy for a successful birth, and it is helpful in many ways. However, women who don’t absolutely need it should avoid it, as there are certainly risks associated with the medical procedure and the healing process.

Source: Guillermo Carroli et al: Episiotomy for Vaginal Birth. The Cochrane Library July 2008

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