During the birthing process, the baby’s head must move out of the body through the vagina. While the opening of the vagina is naturally created to expand to meet these needs, the baby’s size in comparison to mom’s size may pose a challenge. When the vaginal opening does not appear large enough to pass a baby’s head, doctors may choose to perform an episiotomy.

What is an Episiotomy?
An episiotomy is an incision that widens the vaginal opening. The midline episiotomy extends from the vagina downward toward the anal opening. The medio-lateral episiotomy extends from the vagina to the left or right side of the anus. Both provide the same widening effect and often the choice between midline and medio-lateral is based on doctor preference.

How Common is an Episiotomy?
In the United States, episiotomies are used less often than in other countries like Latin America and India. Episiotomies were once thought to prevent trauma and muscle damage during labor, but the procedure has since been proven to cause the same issues it was created to avoid. Instead of surgically cutting the opening of the vagina, most doctors will allow the vagina to tear naturally. Typically, a natural tear is far smaller than the episiotomy incision. 

After the Baby is Born
After the baby is born, the episiotomy incision will be cleaned and sutured. Localized pain may occur for a short period of time after birth and may be worse when urinating. It is important to use a cleansing solution provided by the hospital or doctor after birth to cleanse the area during every bathroom break. Infection is a risk, but if the area is kept clean this risk is reduced.

Sexual Effects of an Episiotomy
Some women complain of less natural lubrication and painful intercourse after the episiotomy heals. No reports of difficulty reaching orgasm or arousal have been reported.