What is an Episiotomy? Why is it Done?

Episiotomy is a procedure, considered to be helpful in making the process of childbirth more convenient. Also known as perineotomy, this is a surgical procedure which has been performed by the mid-wife or obstetrician to enable a quick labor. If you are wondering what is an episiotomy and why is it done, here is more information for you.

Episiotomy is performed during the second stage of labor by making an enlarged opening so that baby can pass out easily. In this procedure, an incision is done from vulva towards the anus at 90 degree and other options could be from posterior towards the end of vulva which is also termed as medio-lateral episiotomy. It is performed under local anesthesia and the cut is sutured after the delivery.

This technique for aiding the normal childbirth was much popular earlier, but now, practitioners avoid this process owing to many side effects which can affect health. In some countries, episiotomy is common but in some countries, this technique is not very common.

Episiotomy may be performed as medial, lateral, medio-lateral incision, depending on the requirement. Sometimes, a J- shaped incision may have to be made, to facilitate easy labor, depending on the baby’s position and several other factors.

However, this procedure is now controversial as it can be risky in some cases. The anus is very close to the incision and there are chances of damaging the anus or the perineum, which can have severe impact on the mother’s health. But there may be some conditions, when episiotomy needs to be performed.

In some situations, episiotomy is done where child’s health is the prime concern. Let us check out the specific reasons that why episiotomy is done:

• Soft tissue of anal and rectum has to be protected from getting torn away and episiotomy helps to do it in a better way. In such cases, where there are chances of anal tears, episiotomy is done.
• At times, baby descends quickly from vagina which can lead to vaginal tears. In such cases surgical cuts are necessary and episiotomy is done, which ensures easy delivery of the child. Episiotomy also aids easier birth of the baby by protecting the vaginal opening from multiple tears
• If the second stage of labor is prolonged and makes the whole process delayed, it can compromise the health of the mother and the baby. This is when episiotomy is done. Other conditions when episiotomy is done is when the mother is exhausted during labor. In such cases, it is necessary to assist labor with episiotomy.
• If there is fetal distress which indicates changes in the fetal heart rate or due to any reason the baby needs to be delivered urgently, episiotomy is done.

In some complicated deliveries, vacuum extraction or forceps assisted vaginal delivery is essential. Here, episiotomy is done as it reduces the resistance of vaginal opening and requires lesser force to push baby’s head out.

Breech presentation or legs first condition makes baby’s bottom pass through cervix before the head. In this case, episiotomy provides additional space to move the baby out from vagina. In fact, episiotomy is done commonly when the baby is overweight and shoulder dystocia makes it tough for the baby to pass through the birth canal.

Occiput anterior or head first presentation makes the head come out of vagina first but with abnormal positions of baby’s head the situation may be difficult. Delivery of twins may sometimes need special assistance. In such cases episiotomy is done to provide adequate room and avoid any kind of complications at a later stage.

Although, episiotomy is done to prevent abnormal tears in the vagina, anus and the perineum, it is important that episiotomy is carried out in the correct manner. This procedure must be performed by trained and qualified experts. Episiotomy must be done, only when it is absolutely necessary. Some side effects of episiotomy like pain, bleeding, improper healing of the wound, etc. should be kept in mind. Proper rest and medical advice must be followed after the procedure to ensure proper healing and recovery.