Mother and Baby

Episiotomies – The Lowdown

Section: Labour & Birth

Episiotomy. The idea may seem scary (or just plain unthinkable), but if needed, it could make recovery from birth easier

While there probably isn’t one mum-to-be who would choose to have an episiotomy, it can help your labour along – especially if you’re overtired, your baby needs a helping hand making his grand entrance or it looks like your baby needs more space to be delivered.

If you do need an episiotomy, you’ll be completely numb down there and won’t feel a thing. Plus it can prevent a tear from happening.

What is it?

An episiotomy is when your midwife makes a cut in your perineum (the area between your vagina and anus) to make the opening of your vagina wider. The cut will be made large enough for your baby to fit through but will be done with extreme precision so not to damage anything permanently.

Why is it needed?

Episiotomies are done for loads of reasons. Your baby may show signs of distress and need the delivery to be quicker and it can be a way to make space if ventouse or forceps are needed.

You may need an episiotomy to help things along if your baby is breech or premature or if you have high blood pressure, so you don’t have to push so hard. Or you may be completely exhausted from labour and need a little help to cross the finish line.

Whatever the reason, it’s not your fault. ‘Unfortunately, an episiotomy is one of the things that women can feel badly about after giving birth,’ says Melanie Every of the Royal College of Midwives. They often feel they’ve failed in some ways, which of course they haven’t.

An episiotomy can reduce the risk of a tear, and will be quicker to recover from.

While there probably isn’t one mum-to-be who would choose to have an episiotomy, it can help your labour along

How is it done?

Lying down with your feet in stirrups, your perineum will be cleaned with antiseptic and numbed with a local anaesthetic. If you’ve already had an epidural, this may be topped up to completely deaden the area. But either way, you won’t feel a thing. If you do, alert your midwife immediately.

The cut is made with a pair of special scissors or a scalpel at a slight angle. Don’t be surprised if your baby is born almost immediately afterwards – this is completely normal for this procedure. 

Once your baby has arrived, you’ll be stitched up with a dissolvable thread – saving you a trip back to the hospital to have the stitches removed. This takes around 30 minutes but no doubt you’ll be completely preoccupied by your beautiful baby and will barely think about what’s going on down there.

What’s the recovery like?

You should feel back to normal within about six weeks of giving birth as the perineum tends to heal quickly. It’s very rare that you’ll need anything re-stitched, but if you do then your midwife advise.

‘A woman’s general health and her level of hygiene has a great effect on how well an episiotomy heals,’ says Melanie. ‘A good after-care routine should include a healthy, balanced diet and regular bathing.’ Changing your maternity pads regularly will help to lower the risk of infection.

Don’t overtire yourself – your body has gone through a lot so exercise and sex will go out for the window for the time being. Stay in your slouchy clothes, forget about doing your make-up and let your partner do the housework. Give yourself time to heal and enjoy this precious time with your newborn.


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