Cutting the vagina during childbirth: Episiotomy

Sometimes, in order to allow labour to proceed smoothly, the vagina opening will have to have to be widened to allow this. This method of widening the vagina involves a cut that is made through the vagina and is called an episiotomy. This may happen because a baby is too big or that the labour is not going as fast as it should and waiting may place both mother and baby at risk. There are benefits to this as it helps stops the vagina from having more serious tears which may have more time healing, the frequency of this happening has reduced but however, in some cases, it may come in handy


The medical community is still split on this as there have studies saying that it’s risks and complications outweigh the benefits as most women have had painful sex and there is not much protection offered to the integrity of the pelvis after this is done or protection to the baby


Why is it done:

  • If labour is prolonged
  • If the fetus is distressed, this just means that the baby needs to come out quickly as the heart rate is changing or the movements, any further delay may lead to complications
  • If we require tools to help deliver the baby, for example, Vacuums
  • If the baby is breech
  • If you are having a twin delivery or more
  • If you are having a big baby
  • If the baby’s head is not well positioned


How is it done:

Before it is done, the area to be cut is usually numbed with anaesthesia, this helps to reduce the pain.

Then a 1 to 3-inch cut is made through the vagina, either in a line to the anus or diagonally just shy of the anus.

The midline cut has the risk of extending to the anus but heals faster, while the diagonally is reported to be more painful and heals slowly but is reported to be safer

After the baby is delivered, the cut is stitched back with sutures that do not need to be removed.



How to care for episiotomy:

Managing pain is important at this point and so analgesics will be given,

An ice pack will be placed over the area to reduce pain and swelling, always keep the area dry to avoid it becoming infected.

Sitz baths are important in reducing infection, a bowl of warm water with salt added to it, then you are required to sit in this bowl for about 20 minutes 3 to4 times in a day.

Don’t rub the area when cleaning, better to dab or blot while cleaning, a hand dryer may be useful in drying the area,

Sex should only be attempted after it has completely healed, this takes about 6 weeks after delivery, make sure a doctor looks at the site to make sure it has fully healed


IF you notice any swelling or discharge from the site, please see your doctor, it is possible for the wound to break down or heal poorly

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