One argument for doing this kind of surgery is to prevent tears or rips around the vaginal opening. They may befall as the vaginal opening stretches to adapt itself to the baby coming out. After the delivery, the surgeon or midwife uses stitches to heal the episiotomy and tears, if any occurred.
The two commonest types of episiotomy are the median episiotomy (the midline) and the mediolateral episiotomy.
During the midline episiotomy, the surgeon or midwife cuts down from the vaginal opening, straight through the skin and the adjacent tissues directly below, for about two inches. It is an easy incision that causes minimal damage for the tissue and can be healed easily, yet it can cause trouble if the incision persists to tear in the same direction further under the delivery pressure. Also, a tear expanding from the midline episiotomy may reach the rectum and create a serious wound, difficult to heal. This may lead to the loss of gas or stool control (fecal incontinence) afterwards.
The mediolateral episiotomy is performed at a certain angle from the lower section of the vaginal opening. This procedure is performed to reduce the possibility that any extra tearing will reach the rectum after the episiotomy. However, such tears can still occur. This kind of episiotomy touches deeper muscle and thus causes considerably more blood loss. The recovery from the mediolateral episiotomy is more painful.
If you undergo an episiotomy, it may take several weeks of recovery. Your health care provider must give you recommendations as to prevent infection and to keep the stitched area clean. The episiotomy site will be painful during the first few post-surgical days. It will be sore for a few weeks, too. Your health care provider will give you the needed pain medication (an anesthetic spray) to decrease the pain. Until the surgery recovers, you may need to sit on cushions or a special doughnut-shaped pillow. At your next medical appointment - normally 6 weeks after the delivery - your health care provider will check the episiotomy area to make sure that no infection occurred.
Why is an episiotomy necessary?
Even after you read such unpleasant things about episiotomy, there are certain conditions in which episiotomy common uses consider a necessity and perhaps a way to avoid the far more expansive procedures like cesarean birth, in which the child is removed through the abdomen by surgical means). For example:
If the fetus is having trouble during the delivery or the mother is too tired to push the baby, an episiotomy may lessen the length of labors and make the delivery go faster. If the delivery occurs earlier than the term, an episiotomy may reduce the compression of the fragile head of the baby. If the doctor uses forceps (a special surgical instrument) to pull the stuck baby out from the birth canal, episiotomy is often necessary to make space for the forceps. If the baby is coming out with its bottom first an episiotomy can help speed and ease the delivery bringing less harm to the baby.
So now you know. This isn't the kind of thing you'll probably talk about over dinner, but for a pregnant mother it's an important subject none-the-less.