An episiotomy is a cut made to widen the opening of the vagina. It is done toward the end of labor to keep the vaginal tissues from tearing as the baby is born.
Who is a candidate for the procedure?
Usually, the doctor or midwife attending the birth decides whether to do an episiotomy. An episiotomy may be done when:
- the vagina cannot stretch enough to allow the baby to pass through
- a baby is thought to be large, for example, more than 9 pounds
- monitors show that the baby may be in distress or not getting enough oxygen and needs to be born quickly
- the vaginal opening starts to tear as the baby's head appears
- the baby's shoulder is blocking the birth canal
Routine episiotomy is no longer a part of evidence-based maternity care. All episiotomies should be done for a specific indication.
How is the procedure performed?
As the crown of the baby's head pushes through the vaginal opening, an anesthetic is injected in the mother's perineum to numb it. The perineum is the skin area between the vagina and anus. A cut 2 to 3 inches long is made there. After the baby is born and the placenta is delivered, the cut is stitched up.