An episiotomy is a surgical incision in the perineum, used to enlarge the vaginal opening during vaginal childbirth. (See diagram below)
Picture this: a woman giving birth must lay down on her back, which reduces the size of the opening of the birth canal, and then undergo an episiotomy to make the opening bigger!
Where's the logic in that?
In many hospitals episiotomies were and are still routinely performed. In the USA, over 30% of women giving birth are reported to undergo this procedure1,2 and in other countries the statistics may be higher.
However, evidence-based research shows that, in general, the outcomes are not benefitting women as intended.
According to the Coalition for Improving Maternity Services, rates of episiotomies should be 20% or less, with a goal of 5%.3
It is your responsibility to find out policies and actual rates of episiotomies by your caregiver/s and state your preferences clearly in your birth plan.
If you wish to avoid this surgery, you need to state this clearly and have a plan to avoid it. If necessary, you may need to find an alternative caregiver or an alternative birth venue which will allow you the type of birth experience you wish for.
Click here for Tips to Avoid Episiotomy and Tearing.
The medio-lateral incision, which slants away from the rectum is the most commonly used incision as it reduces tearing into the anus.
The median incision which is directly back towards the rectum causes less blood loss, heals well and is easier to repair but has a greater risk of tearing through to the anus.
1. Popovic JR. 1999 National Hospital Discharge Survey: Annual summary with detailed diagnosis and procedure data. Vital Health Stat 13 2001; (151):i-v, 1-206.
2. Martin JA, Hamilton BE, Ventura SJ, et al. Births: Final data for 2000. Natl Vital Stat Rep 2002; 50(5):1-101.
3. CIMS, Mother-Friendly Childbirth Initiative, http://www.motherfriendly.org/mfci.php, retrieved 07/09/2010
4. Burn, E., Greenish, K. (1993). Water Birth. Pooling information. Nursing Times 89 (8): 47-9.
5. Garland, D., Jones, K. (1997, June). Ibid.
Disclaimer: All information is provided for informational purposes only, although every effort is made to provide accurate and current information.
The site content is not intended to be or to substitute for medical advice, diagnosis, or treatment.
Always seek the advice of a suitably qualified health care professional regarding your individual medical needs.
Pregnancy and Giving Birth.com is not responsible nor liable for any advice, course of treatment, diagnosis, services or products obtained via this website.