A Guide to Episiotomy and What You Need To Know

Episiotomy: It’s not an easy word to say, but it’s not as difficult to understand as some think. Episiotomy refers to a surgical incision which is used to enlarge an expectant mother’s vaginal opening in order to assist her with delivering her baby.

An episiotomy might be called for in any of the following situations: When birth is imminent and there has been insufficient time for the perineum to slowly stretch; when the child’s head is too big for the vaginal opening; when the child appears to be in distress; when a vacuum or forceps assisted delivery is required; when a breech presentation creates a complication in delivery; when you can’t control your pushing.

Let’s talk, then, about how an episiotomy is done.  You’ll probably be given an epidural. If so, you normally won’t need any more anesthetic. If it’s not given, then a local anesthetic such as a pudendal block will be required.

The doctor ensures that the mediolateral incision is angled away from the perineum and vagina and straight into the muscle.  He or she performs the midline cut by cutting straight down, between the anus and vagina and into the perineum.

Of course, the best option is to avoid the need for an episiotomy.  And there are things you can do to reduce your odds. Here are a few things you can do to lower your chances of needing an episiotomy:

Maintain good nutritional habits, since healthy skin will stretch more easily.  Do regular Kegel exercises.  Use support and warm compresses during delivery.

Make use of perineum massage methods. And finally, don’t lie on your back as you push.

Side effects of an episiotomy include possible bruising, infection, bleeding, swelling, and an extended healing time.  You might also have a painful scar which will only heal after a period of abstinence from vaginal sex.

If, following an episiotomy, you find that you are experiencing pain; there are some relief options available for you.  There are also options to relieve tearing you might be experiencing.

Some of the best options for both include: cold packs applied to the perineum (Be sure you ask your doctor about maxi-pads which have cold packs built in); taking a sit bath (a portable bath placed over a toilet which lets warm water cover the wound); using Tucks Medicated Pads; using KY Jelly or other personal lubricant when you begin resuming sexual intercourse; washing with a squirt bottle rather than wiping when using the bathroom (You then pat yourself dry).

If you feel strongly about not wanting an episiotomy, make sure you clearly state this in your birth plan.  Explain that you want it done only if it’s absolutely essential.  Also, be sure to speak with your doctor or other health care professional regarding an episiotomy during one of your regular prenatal visits.

Like many procedures that might be possible during pregnancy and labor, episiotomy is not nearly as scary once you know all the facts. Then, as an informed mother-to-be, you’re equipped to make the right choices for yourself and your baby.

Related posts: