What is an Episiotomy? – Benefits, Risks, Preventive Measures, After Care

An episiotomy is an incision or a cut performed between the rectum and vagina for increasing the vaginal opening to help in the easy delivery of the baby. Prior to delivery an incision is made in the vaginal opening by the obstetrician.

  1. A mediolateral incision is done from vagina into the vaginal muscles.
  2. A straight midline cut is done between vagina and anus.

Incision enlarges the vaginal opening. After the baby and placenta comes out, the cut is sutured in layers.

Episiotomies are performed to avoid vaginal tears during childbirth. These are performed for the easy delivery. This is required when the baby’s heart rate decreases. This is also needed, if baby’s shoulders or head are too big than the mother’s vaginal opening or if the baby is in breech position (that is, buttocks or feet coming first).


Benefits of episiotomies include:

  • Prevents tearing
  • Heals easier than tears
  • Protects against incontinence
  • Speeds up birth
  • Protects against relaxation of pelvic floor


Apart from benefits, episiotomy has some risk factors. Risks of episiotomy include:

  • Increased pain
  • Infection
  • Healing time is longer
  • 3rd and 4th degree vaginal tears
  • Increases discomfort when intercourse resumes


Episiotomies are not always necessary. You can reduce the chances of episiotomy by following the below measures.

  • Prenatal perineal massage
  • Good nutrition
  • Kegels exercise
  • Prenatal discussion with the health care provider
  • Warm compresses, support during delivery and perineal massage
  • Control pushing during second stage


  • To relieve pain, a

    sitz bath

    is given to the patient.

  • Application of ice packs on the sanitary napkin for soothing the tissues.
  • Medications are given to reduce the pain and inflammation.
  • Frequent perineal wash is needed to reduce the risk of infection.

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