What Is It?

An episiotomy is a small incision made at the bottom of the vaginal opening, through the perineum. This incision is intended to prevent tearing of the vaginal wall and perineum during childbirth.

What Conditions Is It Designed to Treat?

If a woman’s vaginal opening has not relaxed enough to accommodate the child’s head, an episiotomy may be necessary to facilitate delivery.

How Is the Procedure Done?

While the patient is in the process of delivery, the doctor may determine that an episiotomy is necessary to enlarge the vaginal opening. A small incision is made in the vaginal wall and perineum to decrease the likelihood of tearing. There are two different incisions: midline–a straight incision; medialateral–an angled incision.

What Are the Potential Risks?

Potential risks are the same as with a tear that occurs during labor and delivery: damage to the muscles around the vagina and rectum, and the potential for bleeding and infection.

What Are Special Instructions After the Procedure?

Patients can return to normal activities immediately but should refrain from sexual intercourse, douching, or tampon use for several weeks following the procedure. Warm sitz baths can help to relieve pain and discomfort. If the patient notices any bleeding or develops signs of an infection such as fever and chills, they should contact a physician immediately. Most episiotomies heal with no problems.

Thomas G. Stovall, M.D.
Dr. Stovall is a Clinical Professor of Obstetrics and Gynecology at the University of Tennessee Health Science Center in Memphis, Tennessee and Partner of Women’s Health Specialists, Inc.