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Home > Living Well > Health Library > Episiotomy and Perineal Tears
An episiotomy (say "eh-pih-zee-AH-tuh-mee") is a cut the doctor or midwife makes in the perineum (say "pair-uh-NEE-um"), which is the area between the vagina and anus. It is done to help deliver the baby or to help prevent the muscles and skin from tearing.
The cut is made just before the baby's head comes out of the birth canal. It is stitched up after the birth.
There are times when an episiotomy is needed—for example, if the baby's heart rate drops too much during pushing or if the baby's position is causing problems. The decision cannot be made until delivery. Episiotomies are more common with first-time deliveries.
Routine episiotomy is not recommended. Experts say that episiotomy is usually not needed during most births.footnote 1
In the past, episiotomy was a very common part of childbirth. Many doctors no longer do episiotomies routinely. But a few still do. If you have a concern about this, talk to your doctor or midwife ahead of time.
It's not uncommon for the perineum to tear during birth. But there are steps you can take to help prevent this:footnote 2
If you had an incision (episiotomy) or a tear in the area between your vagina and anus (perineum) during delivery, your doctor or nurse-midwife will repair it with stitches, using a local anesthetic. An ice pack will be placed against your perineum to ease pain and swelling.
Recovery from an episiotomy or tear can be uncomfortable or quite painful, depending on how deep and long the incision or tear is. Pain typically affects sitting, walking, urinating, and bowel movements for at least a week. Your first bowel movement may be quite painful. An episiotomy or tear is usually healed in about 4 to 6 weeks.
To reduce pain and promote healing:
American College of Obstetricians and Gynecologists (2006, reaffirmed 2011). Episiotomy. ACOG Practice Bulletin No. 71. Obstetrics and Gynecology, 107(4): 957–962.
Beckmann MM, Stock OM (2013). Antenatal perineal massage for reducing perineal trauma. Cochrane Database of Systematic Reviews (4).
Current as of:
June 16, 2021
Author: Healthwise StaffMedical Review: Kathleen Romito MD - Family MedicineAdam Husney MD - Family MedicineKirtly Jones MD - Obstetrics and Gynecology
Current as of: June 16, 2021
Author: Healthwise Staff
Medical Review:Kathleen Romito MD - Family Medicine & Adam Husney MD - Family Medicine & Kirtly Jones MD - Obstetrics and Gynecology
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