12/09/2025
An episiotomy is an incision or a surgical cut performed at birth to give a baby more room to emerge is baby is unable to get passed the vaginal opening.
For a long time they were believed to be necessary for a child to be born. Research since then has shown that it is more beneficial for women to tear naturally during childbirth.
There are also ways to prevent tears and avoid needing an episiotomy. Such as:
🔹Switching pushing position
🔹Using gravity
🔹Avoid being completely numbed by epidural block
🔹Try different maneuvers that will give baby more room
🔹Breathing through pushing
🔹Applying lubricant &/or warm wet cloth
Episiotomies should only be performed when it is truly medically necessary such as a baby in severe distress during the pushing stage.
What is the issue with episiotomies? The surgical cuts do not follow natural tissue which leads to:
👉🏾Increased risk of 3rd- or 4th-degree tears.
👉🏾More painful and slow to heal.
👉🏾often require stitches & longer healing time
👉🏾 Increased risk of infection
In the U.S today 5–10% of births involve an episiotomy overall.
Some countries like Taiwan or Brazil show episiotomy rates of 90-100%. That’s scary!
However research shows that true medical necessity in birth would have episiotomies performed in 1–3% of births.
Long term risks include:
Weakened pelvic floor strength
Increased risk of prolapse symptoms later in life
Long term pain during s*x
Chronic pain in perineum
Nerve damage
Increased risk of 3rd- or 4th-degree tears in future births
Higher risk of a**l incontinence
Consent should ALWAYS be given before an episiotomy is performed.
Local anesthesia should and is offered/administered before one.
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