An episiotomy is a small surgical cut made in the perineum, the area between the vagina and the anus, during childbirth. It widens the vaginal opening when the baby needs to be born more quickly or with help.
Doctors and midwives do not perform an episiotomy routinely. It may be suggested when the baby is showing signs of distress, when forceps or a ventouse (vacuum) are needed, or when a severe tear seems likely. The person giving birth should be asked for consent first, unless it is an emergency.
The area is numbed with a local anesthetic, or an epidural is topped up, before the cut is made. After the baby and placenta are delivered, the cut is closed with dissolvable stitches. An episiotomy is a planned cut, while a third-degree tear is a deeper tear that happens on its own and may need repair in an operating room.
Most episiotomy wounds heal within a few weeks, although the area can feel sore or tender for longer. Keeping the area clean, changing pads often and resting can help with comfort. Pain when sitting is common at first.
Contact a midwife or GP if the pain gets worse, the wound smells bad, there is pus or a high temperature, or if pain during sex continues months later.
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