Episiotomy: Is It Really Necessary?

Episiotomy – a cut to my vagina? You must be thinking “No way. Ever.” But is it really so bad? What is an episiotomy, how it is done, what anesthesia is used, and until when does the pain last?

What is episiotomy?

pregnant woman labor hospital doctor

An episiotomy is a cut or laceration to the perineum (the area between the anus and the external genitalia) to enlarge the vaginal opening. This is used during labor when the following occurs:

  • The perineum is not stretched enough, and a cut is deemed necessary to prevent a tear. (A clean cut is easier to stitch up than a tear that occurs naturally)

  • The labor takes a long time and the baby doesn’t seem to be doing well

  • Forceps or a vacuum extraction has to be used

When an episiotomy is done, labor can proceed smoothly. An episiotomy should be administered, however, only when deemed necessary.

Episiotomy stitches and anesthesia

labor doctors woman childbirth hospital

An episiotomy is about 1.2 in (3 cm) long. The anesthesia used by hospitals or birthing centers might be different, but usually, local anesthesia is used. At times, no anesthesia is used – wait, don’t freak out! This is not because moms want to save on the costs incurred by getting an anesthesia. It’s because the pain of labor overrides all pain of the episiotomy and there is no need for an anesthesia. Some moms don’t even know an episiotomy took place because they didn’t feel a thing.

After birth, there is a need to stitch up the perineum. Once the stitches are done, you only need to wait about two weeks before they are ready to go. The stitches will usually dissolve on their own – they are usually are seen when you wipe after going to the restroom and appear as small black strings.

For how long will the pain last after an episiotomy?

woman lower back pain bed

The pain at the part where an episiotomy was done will usually last for 3 to 4 days. However, it can take up to a week for the cut to be completely healed, so you might feel pain in your nether regions for awhile. Some moms have mild pain and this can cause them discomfort for a whole entire month. There’s no telling how long you’ll take, but keep in mind that it can last for some time. After you’ve been discharged from the hospital, continue to monitor your condition.

You might feel pain when you’re sitting down. If so, grab a donut-shaped cushion to help take the stress off your buttocks when you sit, and this will help ease the pain.

An episiotomy is done with a pair of scissors and the clean cut is said to leave a scar that’s not as bad when the perineum tears on its own. Even if a scar is left behind, it’s really in a well-hidden area of your body, so you don’t worry too much about it! If you don’t tell, nobody will know!

I don’t want to have an episiotomy! What should I do?

pregnant women friend research

No amount of convincing can get you to change your mind about the episiotomy? If you’re truly afraid of it, you might be wondering what you can do to avoid having one.

What you can do is to prepare for labor. Practice hard at your breathing technique so that you don’t lose control over it even in the midst of labor. You need to wait until your perineum is soft and stretched before you push.

Perineal massages before labor can also help make your perineum softer. Think of the episiotomy as a shortcut to help you deliver quickly! Instead of worrying too much, do what you can and leave the rest in the hands of your doctors!