Episiotomy is a medical procedure, which is performed by gynecologists during childbirth. It is not very popular among women and it is not performed in every birth. It is intended to prevent birth complications and injury of the delivering woman.


Episiotomy is an incision of the back wall of the vagina and perineum performed with scissors. Perineum is the tissue between the vaginal opening and the anus. There are several types of episiotomy, depending on the direction of the cut. The procedure is performed when the child's head is present in birth canal and when the perineum is significantly strained by the head circumference. The incision is only minimally painful, but application of local anesthesia is possible. Right after the birth, the wound is sewn immediately. Further approach should include careful wound care with adequate local hygiene, which should enable quick and total healing.




Schema - possible performance of episiotomy during childbirth



The main importance of episiotomy is to protect women against tissue damage. The distension of the perineum during the birth can cause tearing in the vaginal wall that can locally spread to nearby skin and muscles of the pelvic floor. The most serious cases may even damage the anal sphincter, resulting in fecal incontinence. Episiotomy is (quite logically) performed when the child has a greater circumference of the head or when the perineal muscles are inadequately relaxed.


Although the need to perform an episiotomy can not be completely prevented, the woman can try to lower its necessity. The doctors usually recommend training the muscles of the pelvic floor (e.g. Kegel exercise) and regular massages of the perineum.


Some women complain of certain pain in time period after the procedure and certain deterioration of quality of sexual intercourse. However, these troubles usually gradually disappear.


The main advantage of this procedure is prevention of perineal injury and especially prevention of rectal damage, which could otherwise result in incontinence of stool.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Contact: jiri.stefanek@seznam.cz
 Sources: basic text sources