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Episiotomy: what is it?
An episiotomy is an incision on the vaginal wall to prevent severe tearing during delivery. It is usually performed when your cervix is dilated 10cm or more. The incision will be made with scissors or a scalpel under local anaesthetic and sutured after delivery. Episiotomy cuts are made in the perineum, which is the area between the vaginal opening and anus. Healthcare provider believe a surgically planned incision will heal better than a spontaneous tear and prevent problems like incontinence after delivery. However, the frequency of routine episiotomies in deliveries decreased from 65% to 20% in the past 25 years, since more evidence is arising to indicate that the procedure is not as beneficial as previously believed.
When is an episiotomy necessary?
An episiotomy is used when delivering a large baby or one who is descending quickly. It also helps to accelerate labor for a baby that has a concerning heart rate. You can potentially avoid the need for an episiotomy by doing perineal massages with your fingers around your vagina and anus prior to delivery--this helps the skin in the area become more stretchy.
Drawbacks of episiotomies
According to recent research, women who undergo episiotomies bleed more in the final stage of labor and have longer, more painful recoveries than women who have spontaneous tears. Additionally, it increases the risk of infection and prolongs the time until comfortable intercourse. An episiotomy could even make you more prone to serious tears through the anus during delivery and damage your pelvic floor muscles.
Recovering after an episiotomy or spontaneous tear
You’ll get sutures to repair the tear that will dissolve after a few weeks. Most women don’t experience pain beyond the first week after delivery, but more severe tears can cause discomfort for over a month. To cope with the pain, you can apply ice packs or take ibuprofen or acetaminophen (stay away from aspirin while you’re breastfeeding). Reduce irritation by changing your sanitary pad often and using a squirt bottle to wash off urine. Make sure to keep the area clean, and try not to sit for long periods of time. Don’t forget your handy-dandy kegels to improve pelvic floor muscle tone. You should be completely healed 4-6 weeks after delivery.
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Sources
- DE Rizk, MN Abadir, LB Thomas, F Abu-Zidan. "Determinants of the length of episiotomy or spontaneous posterior perineal lacerations during vaginal birth." International urogynecology journal and pelvic floor dysfunction. 16:5 pg 395-400. Web. 1/20/2005.
- Pregnancy.org Staff. "Perineal Massage." Pregnancy.org. Pregnancy.org, n.d. Web.
- Mayo Clinic Staff. "Episiotomy: When it's needed, when it's not." Mayo Clinic. Mayo Clinic, 7/30/2015. Web.
- G Carroll, L Mignini. "Episiotomy for vaginal birth." Cochrane. Cochrane, Januari 21 2009. Web.
- "Episiotomy or tear during childbirth." NCT. National Childbirth Trust, n.d. Web.
