Understanding Episiotomy

On occasion, an episiotomy or surgical incision is used to enlarge the vaginal opening to give more room for the baby to come through. There are certain measures you can take in order to reduce your chances of an episiotomy.  There are a few side effects associated with having an episiotomy.

 

Why Would I Need an Episiotomy?

There are several reasons why an episiotomy may be needed:

• The baby is coming quickly and your perineum doesn’t have enough time to stretch slowly

• The baby’s head is too large to come through

• The baby appears to be in distress

• Forceps or vacuum delivery is needed

• The baby is breech and help is needed to delivery him

• You are having difficulty controlling your pushing

How is an Episiotomy Performed?

If you haven’t had any anesthesia (epidural) then the doctor will give you a local anesthetic in the perineum. This is also called a pudendal block. A mediolateral cut is made down and away from the vagina into the muscle. A midline cut goes straight down from the perineum, from the vaginal towards the anus.

Avoiding an Episiotomy

There are certain measures you can take in order to reduce your chances of an episiotomy:

• Eating well and keeping hydrated will make your skin more elastic

• Strengthening your pelvic floor muscles with Kegel exercises

• Maintaining a slow progression of labor

• Having support during labor

• Avoiding laying on your back during the pushing stage

Risks Associated with Episiotomy

There are a few side effects associated with having an episiotomy:

• Possibility of infection

• Bruising and swelling

• Bleeding

• More time needed to heal

• Scar tissue at the site which may mean prolonged abstinence from intercourse

• Incontinence

Reliving Pain for Episiotomies and Tears

Some of these suggestions may help reduce the pain and swelling:

• Putting cold packs on the perineum can make a big difference and speed up recovery.

• Borrow or rent a sitz bath, which lets you soak the wound in warm water.

• Use medicated pads.

• When you resume intercourse use a personal lubricant to make it easier.

• Use a squirt bottle to rinse after urinating and pat dry, rather than wiping.

Avoiding an Episiotomy

If you don’t want an episiotomy make sure this is clearly stated in your birth plan and talk to your health care provider about avoiding an episiotomy during a routine birth. Doing perineum stretching exercises and Kegels can make a big difference in ensuring that your pelvic muscles and perineum are ready for birth.