Episiotomy: When it's needed, when it's not

An episiotomy was once a routine part of childbirth. Today, the procedure is recommended only in certain cases. Here's what you need to know about episiotomy risks, benefits and recovery. By Mayo Clinic Staff

An episiotomy is an incision made in the perineum — the tissue between the vaginal opening and the anus — during childbirth. Although an episiotomy was once a routine part of childbirth, that's no longer the case.

If you're planning a vaginal delivery, here's what you need to know about episiotomy and childbirth.

The episiotomy tradition

For years, an episiotomy was thought to help prevent more extensive vaginal tears during childbirth — and heal better than a natural tear. The procedure was also thought to keep the bladder from drooping and the rectum from protruding into the vagina after childbirth.

Today, however, research suggests that routine episiotomies don't prevent these problems after all.

Recovery is uncomfortable, and sometimes the surgical incision is more extensive than a natural tear would have been. Infection is possible. For some women, an episiotomy causes pain during sex in the months after delivery. An extensive episiotomy might also contribute to fecal incontinence after childbirth.

The new approach

Routine episiotomies are no longer recommended. Still, the procedure is warranted in some cases.

Your health care provider might recommend an episiotomy if:

  • Extensive vaginal tearing appears likely
  • Your baby is in an abnormal position
  • Your baby needs to be delivered quickly

If you need an episiotomy and you haven't had any type of anesthesia or the anesthesia has worn off, you'll likely receive an injection of a local anesthetic to numb the tissue. You shouldn't feel your health care provider making the incision or repairing it after delivery.

Aug. 11, 2012 See more In-depth