An episiotomy is a surgical incision made between the vagina and rectum. It is done while in the labor process to create a larger opening for the baby to be delivered. Not all women require an episiotomy and for the most part, the decision for your doctor or midwife to perform one is your choice. However, there are situations where it is absolutely necessary or in your best interest to do so. I know it sounds a little scary, but the more you know about it and what to expect, the better decision you can make before it comes down to it.

So why are episiotomies performed? There are several reasons and as always range from minor issues to more serious. When you are in labor your perineum slowly stretches making room for your baby to come out. If you labor too quickly, your perineum may have not had the time to stretch enough. Passing up the episiotomy could result in tearing which is painful in itself. Complications such as the baby’s head being too large, distress in the baby or a need for forceps or vacuum to assist your delivery would all require you to have an episiotomy for a safer delivery.

As if labor and delivery aren’t painful enough, try to make your decision as soon as possible about having the episiotomy once requested by your provider. They can provide pain relief for the episiotomy procedure so you won’t feel it but they can’t for tearing. Nor can they determine where exactly you will tear or how badly. Moms who want to deliver without an epidural, you still can. The medicinal pain relief they will administer is a local anesthetic to your perineum called a pudendal block. If you have already received an epidural you won’t need the local anesthetic as you should already be clear of pain in that area.

There is no sure fire way that you can take measures to completely prevent the need for an episiotomy during delivery, but there are things that you can do to help reduce your chances. Kegels are a great exercise that you can do and should be doing throughout your pregnancy. Not only will it help reduce the chance of an episiotomy but it also helps to strengthen your pelvic floor for delivery. Eating healthy and good nutrition will do wonders for your skin including having better elasticity. During delivery, use warm compresses and perineum massage to help the stretching process. Also, try to avoid delivery while lying on your back if you can. Lying on your side may be a better position.

 Healing time for an episiotomy is usually 4 to 6 weeks. The incision will be sutured up and depending on what your provider decides to use to do that will determine your recovery time. It is very important to follow all instructions on care of your incision to avoid infection. The hospital should supply you with all you will need to clean yourself properly after using the bathroom such as a peri bottle with water and Tucks Medicated Pads. They can also give you pads that have ice packs in them that you can use while you are there and let you know where to get more if you need them when you go home.