Episiotomy is a surgical procedure, where a cut (incision) is made through the deep and superficial tissues outside and around the vagina and between the anus (called the perineum), with an aim to enlarge the vagina and thus assist in childbirth. It is a relatively common and safe procedure, but is not always necessary. The incisions may be medial – along the mid-line of the body directly between vagina and anus, or lateral – at an angle away from the mid line. The incision is then sutured up.
Here are some of the reasons why it is done, and may be useful –
It is usually believed to be helpful to reduce the chances of perineal trauma (or a tear) or excessive blood loss and also the chances of postpartum problems like pelvic floor dysfunction, incontinence etc.
In case a caesarean section is not advised, but natural vaginal delivery is not happening or taking too long
If the baby is stuck due to reversed or faulty positioning, due to its big size or breathing problems
If the perineal muscles and skin of the mother are rigid, and there is risk of high degree tears around the vagina
Some of the negative points associated with it -
A natural tear usually causes tears only in the tissues required for the child to appear, where as the Episiotomy cuts into the complete perineal tissue.
The natural tears heal faster than the surgery as well as have less chances of infection, pain or causing postpartum incontinence
Though Episiotomies are performed with an aim to reduce chances of perineal trauma, incontinence etc. sometimes, that is exactly what they cause!
Post surgery, there may be problems like -
Pain at the incision points, trouble during elimination and some pain during sexual intercourse
It may leave behind rigid scar tissues at the incision point, instead of metabolically active tissues
It is not uncommon for the incision to develop infection, post surgery
A better way to prevent use of the surgical procedure may be to ensure good nutrition, adequate hydration and include massage, stretching exercises over the pregnancy months, use Kegel exercises and guided and assisted pushing during the labor.
Also remember that good health care providers will not recommend it, at the initial stage much before delivery unless you are diagnosed with any risk factors for delivery like pre-eclampsia etc. They will take the decision to go ahead with it, only if required as the child birth process progresses. Be wary of anyone who advocates it without any justifiable and sound reasons to choose it!
