An episiotomy is an incision made in the perineum — the tissue between the vaginal opening and the anus — during childbirth. A midline incision (shown at left) is done vertically. A mediolateral incision (shown at right) is done at an angle. A midline incision is the easiest to repair, while a mediolateral incision offers the best protection from an extended tear affecting the anal area. Although midline incisions were once the most common type of episiotomy incision, mediolateral incisions are becoming the preferred approach.