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What is an episiotomy?

An episiotomy is an incision between a woman's vagina and rectum that is sometimes made during a vaginal delivery. An episiotomy makes your vaginal opening larger, so your baby can be born faster and more easily. An episiotomy may prevent skin and muscle tears around your vaginal area and rectum.

Why do I need an episiotomy?

  • Your baby is too large to fit through your vaginal canal.
  • Your baby's heartbeat is slower than it should be, or he needs oxygen right away.
  • Your baby needs to be delivered using forceps or a vacuum extractor. These tools help pull your baby out of your vaginal canal gently and quickly.

What happens during an episiotomy?

Your healthcare provider makes a small cut between your vagina and rectum. The cut may be made downward toward your rectum, or sideways toward one of your legs. Your healthcare provider will close the cut with stitches after your baby is delivered.

What are the risks of an episiotomy?

  • Even with an episiotomy, you may still get a vaginal or rectal tear during the birth of your baby. An episiotomy may cause tissue weakness, which increases your risk for a tear the next time you give birth. After an episiotomy, you may get a bruise near your wound that feels hard or painful. You may have swelling and your wound may bleed. You may feel pain when you have a bowel movement.
  • You may get a wound infection or abscess (infected pus pocket) under your skin. Your wound may break open and need to be closed again. A fistula (abnormal tissue opening) may form between your rectum and vagina. A fistula allows gas and bowel movement to enter your vagina. You may get cellulitis, which is a skin infection in the area of your wound. An infection may lead to tissue death. This can be life-threatening.
  • Without an episiotomy, your skin and muscle may tear near your vagina and rectum while giving birth. Vaginal and rectal tears may not heal as well as a cut. You may have bruising, bleeding, and get an infection at the site of the tear. You may leak urine. A tear into your rectum can make it hard for you to hold in gas or bowel movements. Vaginal tears may also cause sex to be painful in the future. If your unborn baby is in danger, it may take longer to push him out without an episiotomy.

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You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

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