All You Need To Know About Episiotomies
Written by Eve Bandusena | Parents Avenue’s Editorial Assistant
While it used to be routinely common in the past during delivery, episiotomies in the modern times are only recommended in specific cases and conditions. Read on to find out all about episiotomies and find out if it could be applied to you!
What Is An Episiotomy?
An episiotomy is a surgical incision made in the perineum, which is the area of tissue between the vagina and anus. The cut in this area is done to widen the vaginal opening before delivering your baby.
In recent years, there’s been a sharp decrease in episiotomies due to its contribution to worsening the tearing that occurs in natural childbirth. Although vaginal tearing is an inevitable byproduct for women who deliver vaginally, it can usually be considered as a minor injury to the vaginal tissue and doesn’t require stitches, however, there are more severe tears that are deeper than that involve the vaginal tissue with the anus and rectum.
Before this, many medical health professionals believed that creating a small cut at the perineum would make stretching a lot easier. But today, we understand that an episiotomy incision can rip to a larger a tear that could’ve been avoided, smaller in size and shallow in depth had the tear happened without an episiotomy. For all mothers-to-be, the probability of an episiotomy occurring is stated below:
An episiotomy has more likelihood in happening if:
• Delivering your first baby
• Using forceps or vacuum birth
• Experiencing a long second stage
• Having an epidural
• When your baby’s head is in an atypical position
• The baby is bigger than usual in size
An episiotomy has less likelihood in happening if:
• Delivering your subsequent baby
• Perineal massage has been done in the late stages of pregnancy
• Your pelvic floor is relaxed
• When you’re birthing the baby’s head slowly between contractions
• If you deliver your baby at a baby center or home
Types of Episiotomy
There are two methods of episiotomy, Midline Episiotomy, and Mediolateral Epistionomy as described on Healthline below:
In a midline episiotomy, the incision is made in the middle of the vaginal opening, straight down toward the anus.
The advantages of a midline episiotomy include easy repair and improved healing. This type of episiotomy is also less painful and is less likely to result in long-term tenderness or problems with pain during sexual intercourse. There is often less blood loss with a midline episiotomy as well.
The main disadvantage of a midline episiotomy is the increased risk for tears that extend into or through the anal muscles. This type of injury can result in long-term problems, including fecal incontinence, or the inability to control bowel movements.
In a mediolateral episiotomy, the incision begins in the middle of the vaginal opening and extends down toward the buttocks at a 45-degree angle.
The primary advantage of a mediolateral episiotomy is that the risk for anal muscle tears is much lower. However, there are many more disadvantages associated with this type of episiotomy such as increased blood loss, increased pain, difficult to repair, and high risks of long term discomfort, especially during sexual intercourse.
Classification of Episiotomies
Dr. Shimatul’s Experience With Difficult Deliveries
Causes for Episiotomy
When delivering more than one baby, having an episiotomy will allow added room at the vaginal opening for the deliverance of the subsequent baby. In instances where twins are in a head-first position, an episiotomy may be done to slow down the delivery of the second twin. In other situations, when the first twin has a normal delivery, the second twin will most likely be delivered in a breech position. Episiotomies will allow room for the delivery.
Recovering from Episiotomy
• Placing a cold pack on the perineum
• Using lubricant during sexual intercourse
• Taking pain medication such as stool softeners
Disclaimer: This article is not intended to diagnose, treat, cure, or prevent any diseases. At Parents Avenue, we strongly recommend all our readers to seek medical advise from your local hospital or clinic. Thank you.
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