Is a planned incision on the perineum (tissue between the vagina opening and the anus) and posterior vagina wall given under local anesthesia during second stage of labor, to help deliver a baby.
Reasons for an episiotomy:
1. Birth is imminent and the perineum has not stretched fully.
2. Baby's head is too big to pass through the vagina opening.
3. Baby is in abnormal position.
4. Baby is in distress and needs to be delivered quickly.
5. During assisted forceps delivery or vacuum extraction.
6. Mother is too tired to push.
How is episiotomy performed;
In-case of an epidural, there will be no need for anesthetics ,but if not local anesthetics also called pudendal block is administered.
An incision is made straight from the vaginal opening down towards the anus and its called midline episiotomy
Another type, is an incision, made from the vagina opening, and angled to the side to avoid the anus and is called mediolateral.
Complications of episiotomy;
- Infection; from poor hygiene.
- Bleeding; from breakdown of sutures or poorly sutured wound.
- Extended healing time.
- Problems with intercourse.
How to prevent the need for episiotomy.
1. Good nutrition; a healthy skin, stretches easily.
2. Avoid lying on the back while pushing.
3. Exercise pelvic floor muscles during pregnancy.
4. Use perineal massage techniques.
Sit bath; put warm water in a bowel that fits into the toilet sit, add few drops of disinfectants then sit over the bowl and let the stem heat the incision site. It reliefs pain, swelling, bruising. Do this at least twice daily.