An episiotomy is a surgical cut that goes through the muscular tissues of the perineum, which is the piece of flesh between your vagina and rectum. Cutting an episiotomy just before the baby emerges was standard practice in most western and some developing nations, and it is still routinely done in many hospitals today. The idea behind the episiotomy is that the baby will come out more easily, and that a man-made incision will heal more cleanly than a natural vaginal tear. An episiotomy was also widely believed to help prevent incontinence later in life. Does a man-made surgical incision really benefit you? To start with, many women give birth vaginally without ever tearing. An episiotomy guarantees that you will have a wound that needs to heal during your postpartum time. Tearing naturally does sometimes happen, and such tears can be tiny or large. Research from the last two decades shows that women who tore naturally during their vaginal birth healed just as soon, if not sooner. There are some cases in which an episiotomy may genuinely benefit a laboring mother and her baby shoulder dystocia, where the baby is stuck in the birth canal, is one such situation. A breech baby or vacuum or forceps delivery are other examples in which the mom-baby dyad need the birth over and done with really quickly, and an episiotomy may help with that.
Alternatives to an epsiotomy
What are the alternatives to an episiotomy, and what do you need to do if you would much prefer to tear naturally during your birth? Talking about this with your healthcare provider (the person or one of the people who will attend your actual labor and delivery) is the best start. Find out how often your healthcare provider cuts an episiotomy, and for which reasons. Say that you do not want to be cut unless there is a real medical reason then discuss specific scenarios. Some midwives say that upright birth positions such as quatting, standing or being on all fours help prevent vaginal tears. You can find out if your healthcare provider is open to that.