Episiotomy
Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR
What is an episiotomy?
An episiotomy is an incision performed between the vagina and the rectum that is used to increase the size of the opening of the vagina to assist in
delivery of a baby.
How common is episiotomy?
An episiotomy is performed in about 40% of vaginal deliveries in the United States, but the prevalence of episiotomy has been decreasing in recent years. For example, 1.6 million episiotomies were performed in 1992 and only 716,000 in 2003. Some countries have significantly lower episiotomy rates than the U.S. In general, episiotomy is less common in Europe than in the U.S.
How is an episiotomy done?
The usual cut (incision) for an episiotomy goes straight
down and typically does not involve the muscles around the rectum or the rectum
itself. Anesthesia in the form of nerve blocks or local injections of anesthetic
are given if the patient has not received regional anesthesia (such an epidural) for the delivery.
What are the advantages of an episiotomy?
An episiotomy can decrease the amount of pushing the mother must do during delivery. It can also decrease trauma to the vaginal
tissues and expedite delivery of the baby when delivery is necessary quickly.
Doctors who favor episiotomies argue that a surgical incision is easier to
repair than a spontaneous irregular or extensive tear, and is likely to lead to a more favorable outcome with fewer complications.
How is an episiotomy repaired?
The repair is straightforward and is fairly simple to perform. The incision is repaired by suturing (sewing) the wound together.
Next: What are the possible complications of an episiotomy, and should an episiotomy be part of a routine delivery? »
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