What is an Episiotomy: Your Basic Questions Answered

What is an Episiotomy: Your Basic Questions Answered

Pregnant women can have many concerns when it comes to giving birth, these can be both big and small. The whole experience is so new to a first-time mum, and there is so many different things that can happen. Today we are looking at the episiotomy, and answering all your basic questions.

Some of the bigger worries about labour can include the level of pain you have to go through, as well as just hoping the baby comes out healthy and without complications. Some women may be concerned that a caesarean section is a possibility, if they have always had a natural birth planned.

I remember one midwife telling me during a particularly long labour; ‘Don’t worry, they always eventually come out.’ That piece of advice was really reassuring at that time because I honestly thought my baby son would never leave the womb.

Some of the smaller worries we have about labour may include:

· I’m afraid of needles – I don’t really want to have one
· What do I wear while giving birth?
· Can my partner stay in the room?
· Will they let me play my own music or burn my candles?
· What if I poop while trying to push my baby out?

Many women may be concerned about having to have an episiotomy. Let’s look at what this is and what it can mean for you.

What is an Episiotomy?

In science-y terms, an episiotomy, also known as perineotomy, is a surgical incision of the perineum and the posterior vaginal wall. The perineum is the small piece of tissue between the vaginal opening and the anus.

This is a minor and very common procedure that can happen during labour, where your doctor will make an incision to help your baby with delivery. Episiotomy is usually performed during the second stage of labour to quickly make the opening bigger for the baby to pass through.

If the baby seems to be in distress and not coming out fast enough, but is already in the birth canal and a caesarean is not suitable, an episiotomy can be the best way to speed up birth.

It can happen when:

· The baby or his head is particularly large
· Forceps or suction is needed to get the baby out
· The baby is breech
· The baby is running out of oxygen or his heart rate rises
· If you have been in labour for a long time and have become too exhausted to push.

Sometimes an episiotomy is not necessary because this wall tears on its own during labour.

How it is fixed?

Your doctor will usually stitch the area up immediately after birth is completed, with dissolvable stitches.

What does it feel like?

Your doctor will usually apply a local anaesthetic to the area so that you won’t feel it. Many women report that between contractions and everything else that is going on, you may not even notice an episiotomy happening.

The area will ache and perhaps sting for several days after the procedure, especially when you go to the toilet. You can try pouring warm water on the area while urinating to stop some of the stinging, or take stool softeners if pooing is causing discomfort.

You can take over the counter anti-inflammatory medication to reduce the pain. You can also use medicated pads or cold packs on the area to numb the area and provide some relief.

A good natural relief involves placing a cool witch hazel pad in the area. Some lavender essential oil rubbed into the area may also help.

How long does it take to heal?

An episiotomy takes around a month to heal. You may feel some pain and weakness around the area for this time.

It shouldn’t affect your ability to lift your baby, as recovering from a caesarean section can, but you may find walking long distances tires you out. Standing and sitting can also be uncomfortable for a while.

What are the possible complications?

Sometimes the more severe episiotomy can take longer to heal, and may cause pain and discomfort during sex in the months following your baby’s birth. Some mothers also have trouble with faecal incontinence after having to have this procedure.

Some women may have the area become infected. If the area doesn’t appear to be healing on time, or if you develop a fever or the wound starts to weep with a yellowish discharge this could be a sign of infection.

It is better to have an episiotomy or a tear?

In the old days, it was thought to be better to have an episiotomy than a natural tear. Whether one is better or worse really depends on the individual circumstances, however, and in many cases, a tear can be smaller and heal better than an episiotomy.

Can you avoid having to have an Episiotomy?

Episiotomies aren’t as common today as they used to be, and are only recommended in certain circumstances now. However, you may not be able to avoid one completely; in the moment your doctor will either recommend one or not. For the safety of the baby, it is advisable to go along with this recommendation.

You can start perineal massage in the last 6 weeks of your pregnancy which may help the area to stretch when the time comes.

Perineal massage is an easy five-minute massage that you give to the area using a lubricant to help the perineum get ready for stretching. For full instructions on how to do this see here.

Resources

Episiotomy: When it’s needed, when it’s not (Mayo Clinic)
Episiotomy (Pregnancy, Birth Baby)