Until fairly recently, obstetricians were in favour of routinely giving episiotomies to labouring women during childbirth. However, the WHO guidelines clearly state that episiotomies should not be routinely performed.
If you’re keen to have a normal delivery, you should know when you might require an episiotomy, what it entails and how long the recovery and healing process can take.
Please read through our list of FAQ’s below. They will serve as a guideline for an informed conversation with your doctor.
Episiotomies – Frequently Asked Questions
What is an episiotomy?
An episiotomy is a cut made in the opening of the vagina to provide more space for the baby’s head to come out.
Why were episiotomies routinely performed?
Episiotomies became a routine obstetric practice because it was believed the procedure would help reduce extensive tearing of the vagina. Doctors also believed that an episiotomy could prevent later complications – like urinary incontinence – that resulted from a vaginal birth.
However, several medical experts do not recommend an episiotomy as a routine procedure because it may cause more complications. Usually, women have natural vaginal tears during a delivery that heal faster, bleed less, and are less painful.
When is an episiotomy required?
An episiotomy can be a helpful procedure in specific cases. For instance, if the delivery needs to be expedited because the baby’s heart rate slows down or more vaginal space is required – like in an instrumental birth – your obstetrician will most likely give you an episiotomy.
What are the risks of an episiotomy?
The risks of an episiotomy include the possibility of an infection to the cut. Women who receive episiotomies may bleed more during childbirth and their recovery also tends to be more painful and more uncomfortable as compared to natural tears. Women face significant difficulties when they have to sit for long hours or when they need to pass urine or stool. Episiotomies tend to heal with more scarring and may lead to painful sex.
Can I do anything during labour to prevent an episiotomy?
One of the best ways to prevent an episiotomy is to practice perineal massage after your 36th week. Your birthing team can also help you try different labour positions to minimise your chances of an episiotomy.
How long does it take for an episiotomy to heal?
While most of the pain tends to subside in the first week after the delivery, full recovery takes an average of two to four weeks.
Will I receive anaesthesia before the procedure?
Yes. You will be given local anaesthesia to numb the area around the vagina.
How can I take care of the wound for easy healing?
While the wound is healing, you can try a few different ways to help ease the discomfort. Placing an ice pack over the stitch line can help with soothing the immediate pain. Later on, sitting in a tub of warm water (sitz bath) two or three times a day for fifteen minutes helps immensely in easing the pain.
Keeping your wound clean by washing it with warm water and applying an antiseptic ointment can help to prevent infections.
Your doctor will most likely prescribe medication to help relieve the pain.
This article has been written with Dr. Anita Sabherwal Anand, Consultant, Obstetrician-Gynecologist at Sitaram Bhartia Hospital in South Delhi. Dr. Anita is a highly qualified gynecologist with 20+ years of experience who is trusted by low-risk and high-risk mothers alike for her guidance on having a healthy pregnancy and delivery.
MBBS, Lady Hardinge Medical College, University of Delhi (1992); MD (Obstetrics & Gynaecology), Lady Hardinge Medical College, University of Delhi (1997); DNB Secondary (Obstetrics & Gynaecology), National Board of Medical Education, New Delhi (1999)
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