| Reasons for Procedure
| Possible Complications
| What to Expect
| Call Your Doctor
The perineum is the area between the vagina and the anus. It is made up of skin and muscle. During an episiotomy, an incision is made in the perineum.
Reasons for Procedure
The incision is made to make the vaginal opening larger during birth. In the past, this incision was common. But it is no longer routinely done.
Your doctor may do an episiotomy if:
The baby is:
or otherwise fragile
- Large and the shoulders may be hard to deliver
- Forceps or a vacuum are needed to assist in the delivery
Some short-term complications may include:
- Difficulty controlling your bowels
Factors that may increase the risk of complications include:
- Severe scar tissue in the area
problems with chronic pain in the vulva
- Short perineum
What to Expect
During a prenatal visit, talk to your doctor about the benefits and risks of an episiotomy.
If you have not had epidural anesthesia during labor, the doctor may use local or
The infant's head will start to stretch the vaginal opening. Special scissors will be used to make an incision in the perineum area.
There are 2 different incisions that may be used:
- Midline incision: starts at the vagina and follows a straight line to the anus
- Mediolateral: starts at the vagina and continues at an angle
Midline vs. Mediolateral Episiotomy
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After delivery of the baby and placenta, your doctor will close the incision with absorbable stitches.
This is done during childbirth.
If you receive anesthesia, you will not feel pain during the procedure. After delivery, most women have discomfort and swelling. You may need to take pain medication.
The usual length of stay for vaginal delivery is 2 days. An episiotomy will not extend your stay.
Your stitches will dissolve in about 10 days. The cut will heal within about 2 weeks. There may still be some soreness until the skin gets its natural strength back. This could take up to 6 weeks. During that time, you may find it uncomfortable to sit or walk.
While you recover:
When your doctor tells you to, do
Kegel exercises. Simply squeeze the muscles you use to stop the flow of urine. This strengthens the pelvic floor and can help the area heal faster.
- Avoid having sex, douching, and using tampons for 6 weeks or as directed by your doctor.
Call Your Doctor
After arriving home, contact your doctor if any of the following occur:
- Signs of infection, including fever and chills, swelling, redness, foul-smelling discharge
- Pain that you cannot control with the medications you have been given
- Bleeding from the episiotomy site
- Continuing problems with
loss of urinary or bowel control
In case of an emergency, call for emergency medical services right away.
Episiotomies. Brigham and Women's Hospital website. Available at:
http://www.brighamandwomens.org/departments_and_services/obgyn/services/midwifery/patient/episiotomies.aspx. Accessed October 8, 2015.
Episiotomy. ACOG practice bulletin No. 71.
Episiotomy. American Pregnancy Association website. Available at:
http://www.americanpregnancy.org/labornbirth/episiotomy.html. Updated August 2015. Accessed October 8, 2015.
Last reviewed September 2015 by Andrea Chisholm, MD
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