An obstetrician might perform an episiotomy on you if your baby has got stuck in the birth canal, has become distressed and needs to be delivered quickly, or if there is a high risk of you having a bad tear in your perineum without it.
What Is An Episiotomy?
This is a medical procedure used during childbirth, which involves an obstetrician making an incision in your perineum (the area between the vagina and the anus).
This is done to enlarge the vagina and speed up the process of delivering a baby. The incision can be a midline incision (vertically down towards the anus) or a medio-lateral incision (diagonally down from the vagina at an angle).
Usually a local anaesthetic is used and the incision is sutured (sewn) up afterwards which dissolvable stitches.
This procedure is perhaps one of the more controversial of childbirth procedures. Years ago it was very common as obstetricians felt it helped prevent women getting problems with their pelvic floor muscles after having a baby and helped minimize blood loss during labour.
More recent research has revealed that allowing women to have a small tear naturally during delivery is better for avoiding the above problems because natural tears are often smaller than the incisions made during episiotomies. Some feel that this procedure can actually make these problems worse, rather than avoid them.
Having an episiotomy can avoid severe damage to the perineum through tearing and can help deliver a baby quickly if the situation becomes urgent.
This procedure can give you worse damage to your perineum than a small tear and can result in problems with your pelvic floor muscles. After you’ve had your baby, sex can be painful for quite a few weeks if you’ve had an episiotomy.
After this procedure you can expect to feel sore for a few weeks while your wound heals. It’s a good idea to take it easy as much as possible and don’t do anything that is going to put too much strain on that area.
You will likely find sitting down a bit uncomfortable. It’s a good idea to use a nursing cushion (shaped like a horseshoe) to sit on because this avoids pressure being put on the sore area.
Your midwife will check your stitches for you when she visits you after you’ve had your baby. This is to make sure they’ve not become infected and are healing well.
It’s a good idea to have a bath every day if you were cut during delivery as this helps to keep the area clean and helps your perineum to heal. Some choose to put salt in their bathwater as this helps with the healing process too.
You will likely feel like you want to avoid sex for at least 5 or 6 weeks, but don’t be surprised if it is still painful or uncomfortable even as long as 15 weeks after having your baby. It all takes time to settle down and fully heal.
With Freddy I’d been through a very long and painful labour and I was very tired. He was getting distressed because the cord was around his neck and it became a bit more urgent to get him out quick because his heart rate was going down with each contraction.
I managed to push his head down the birth canal enough for them to see it, so they abandoned the idea of using the ventouse to pull him out, and the obstetrician performed a medio-lateral (diagonal) episiotomy instead. A few seconds later, Freddy was born.
My perineum was sore for a few weeks and my healing was delayed a little because the top layer of my stitches came undone.
I would say that by about week 15 it all felt pretty much back to normal.
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