Episiotomy

What is Episiotomy?

Episiotomy is the procedure in which a cut is made at the vaginal opening to ensure easy delivery of the baby. It is usually done towards the end of labour to prevent the vaginal tissues from tearing.

There are various degrees of episiotomy that can be done ranging from one to four, depending on the length of the cut that extends between the vagina and the anus. The most commonly performed is the second degree episiotomy. In this, the cut is made from the vagina, halfway till the anus.

When is it done?

Episiotomy is not a routine procedure and is performed only when the vaginal passage is too small for the baby and there is a chance of tearing of the vaginal tissues. Some cases when an episiotomy may be opted for are:

• The baby is too large to be able to pass through the vagina comfortably
• The baby is in distress and labour has to be induced earlier than usual
• The vaginal wall begins to tear as the baby's head emerges
• Some part of the baby's body gets stuck in the birth canal.

What are the advantages?

Though episiotomies are not done as a routine, they may have some benefits:

• Prevent tearing of vaginal tissues which do not heal easily
• Speed up birth when the baby is in distress
• Protect against the ability an uncontrolled tear that may extend into the muscles that control the to hold urine in the bladder

What are the side effects?

There may be:

• Increased risk of infection
• Increased healing time in some cases
• Difficulty in resuming sexual intercourse
• Pain and discomfort.

How can these effects be reduced?

To relieve the pain, a woman may need to bathe the area in warm water for some time till the soreness is reduced. Since the risk of infection is high, the area should be gently cleaned after using the toilet. She should sit on a padded seat that is comfortable and does not put too much pressure on the area. The intake of fluids must be increased to prevent constipation so that no pressure is exerted while passing stools. It is better to avoid sexual intercourse till atleast 6 weeks after delivery to allow complete healing. Painkillers may be taken. Any complication should be brought to the notice of the doctor immediately.