Episiotomy, it is the word that every pregnant woman dreads, and tends to avoid talking about.  An episiotomy is an incision made in the perineum during delivery.  The incision is made by your doctor to help speed delivery and to avoid tearing.  Some doctors perform episiotomies routinely on all patients while others try to avoid them.  It is very important to talk to your doctor about their use of episiotomies, especially if you have a particular preference one way or the other.

Research has begun to show that women who tear spontaneously during delivery tend to recovery in the same or less time as those who have episiotomies.  The general practice for many years was for all women to have an episiotomy, however, the trend has changed (thank goodness!) and they are beginning to be performed less frequently.

Some of the reasons you may find that you need an episiotomy include:

  • The baby’s heart rate slows and the doctor wants to speed up the delivery for the welfare of the baby.
  • You are carrying a large baby and the doctor doesn’t anticipate that extra room will be needed.
  • If the tissue in your perineum begins to bleed and it appears that you may tear in multiple places.
  • You have a doctor that performs episiotomies routinely.

The best thing to do if you wish to avoid an episiotomy is to make sure your doctor does not perform them routinely.  Talk to your doctor about your preferences and make sure you chart indicates you wish to avoid an episiotomy if you can.  Remember, however, that it may be impossible to avoid an episiotomy.  If one is deemed medically necessary it is probably better to go with it than to risk multiple or severe tearing.

Talk to your doctor about the risks of an episiotomy or vaginal tearing.  Be sure you know what limitations you may have after the delivery, what recovery may be like for you, and when your doctor will want to see you post delivery to examine the incision.

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