Episiotomies and Perineal Tears in Childbirth

 Sometimes a doctor or midwife may need to make a cut in the area between the vagina and anus (perineum) during childbirth. This is called an episiotomy.

An episiotomy makes the opening of the vagina a bit wider, allowing the baby to come through it more easily.

Sometimes a woman’s perineum may tear (perineal tear) as their baby comes out. In some births, an episiotomy can help to prevent a severe tear or speed up delivery if the baby needs to be born quickly.

If your doctor or midwife feels you need an episiotomy when you’re in labour, they will discuss this with you. In England, episiotomies are not done routinely.

Up to 9 in 10 first-time mothers who have a vaginal birth will have some sort of tear, graze or episiotomy.

The National Institute for Health and Care Excellence (NICE) recommends that an episiotomy might be done if:

• the baby is in distress and needs to be born quickly, or
• there is a need for forceps or vacuum delivery (ventouse), or
• there is a risk of a tear to the anus

If you have a tear or an episiotomy, you’ll probably need stitches to repair it. Dissolvable stitches are used, so you will not need to return to hospital to have them removed.

The NHS reccommend that you call your midwife or GP if you’ve had an episiotomy or tear and:

• your stitches get more painful
• there’s smelly discharge
• there’s red, swollen skin around the cut (incision) or tear – you can use a mirror to have a look

Any of these may mean you have an infection.