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By Mayo Clinic Staff An episiotomy is an incision made in the perineum — the tissue between the vaginal opening and the anus — during childbirth. Although the procedure was once a routine part of childbirth, that’s no longer the case. If you’re planning a vaginal delivery, here’s what you need to know about episiotomy and childbirth. Doctors do an episiotomy to make it easier for the baby’s head to pass through for delivery and to prevent complications or a vaginal tear.

This cut is made during the second stage of labor right before the baby’s head is delivered. 2  After the baby is born, the doctor uses stitches to repair the incision. An episiotomy is a surgical cut that the doctor makes between the vagina and anus (doctors call this area the perineum) as you give birth. The goal is to extend the vaginal opening so there’s more.

Episiotomies are usually done at the end of the second stage of labor and delivery, when pushing has already started and the baby’s head has appeared at the opening of the vagina. You won’t feel the incision or the repair because the area will have been numbed. The incision is repaired with stitches. An episiotomy is a cut (incision) through the area between your vaginal opening and your anus. This area is called the perineum.

This procedure is done to make your vaginal opening larger for childbirth. Normally, once the baby’s head is seen, your healthcare provider will ease your baby’s head and chin out of your vagina. An episiotomy procedure is a surgical incision used to enlarge the vaginal opening to help deliver a baby.

An episiotomy is a minor incision made during childbirth to widen the opening of the vagina. A perineal tear or laceration often forms on its own during a vaginal birth. Rarely, this tear will also involve the muscle around the anus or the rectum.

Episiotomy needed again with 2nd? r. rwmc. Hi mamas. Wondering if anyone has had an episiotomy for one birth and then gone on to need another next time—if so, what was the experience of the following delivery like? Specifically, did they need to make the same incision? For some reason an episiotomy was the ONE thing I was totally freaked.

An episiotomy is a surgical cut in the skin between the vagina and the anus (the area called the perineum) meant to enlarge your vaginal opening just before the delivery of. An episiotomy is an incision between your vagina and rectum made during a vaginal delivery. An episiotomy makes your vaginal opening larger. This allows your baby to be born more easily and quickly.

An episiotomy may prevent skin and muscle tears around your vaginal area and rectum.

List of related literature:

The procedure is also necessary when the delivery of the baby’s head is progressing at a rate or manner that will badly tear the perineum or when the vagina is not stretching.

“Mosby's Essential Sciences for Therapeutic Massage E-Book: Anatomy, Physiology, Biomechanics, and Pathology” by Sandy Fritz, Luke Fritz
from Mosby’s Essential Sciences for Therapeutic Massage E-Book: Anatomy, Physiology, Biomechanics, and Pathology
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1 It is too early for the perineum to be stretched to the point of tearing; if this should occur later, an episiotomy may be performed.

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If an episiotomy is needed, it should be in the midline and should be carefully repaired.

“Clinical Maternal-Fetal Medicine” by Hung N. Winn, John C. Hobbins
from Clinical Maternal-Fetal Medicine
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After either primary closure of the uterine tear or conservative treatment, the uterus should be massaged per rectum at 3to 5-day intervals to break down adhesions that may form.

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Optimally, an anterior episiotomy sufficient only to expose the urethra should be performed during the late second stage, but occasionally, this procedure must be performed earlier to allow adequate investigation or treatment during pregnancy, for example, in the case of pain and bleeding in early pregnancy.

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from High Risk Pregnancy E-Book: Management Options Expert Consult
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To reduce the risk of a vaginal tear or a rapid birth, you may need to stop pushing to let your vagina and perineum gradually stretch around your baby’s head as it emerges.

“Pregnancy, Childbirth, and the Newborn: The Complete Guide” by Janet Walley, Penny Simkin, Ann Keppler, Janelle Durham, April Bolding
from Pregnancy, Childbirth, and the Newborn: The Complete Guide
by Janet Walley, Penny Simkin, et. al.
Meadowbrook, 2016

During the pushing phase, your practitioner will probably use perineal support – applying gentle counterpressure to the perineum so your baby’s head doesn’t push out too quickly and cause an unnecessary tear.

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Any laceration or episiotomy is repaired.

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If an episiotomy (incision into the perineum to enlarge the vaginal outlet) is necessary, it is done at this time to minimize soft-tissue damage.

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from Maternity and Women’s Health Care E-Book
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Some women do not require an episiotomy, especially if (1) the woman has had previous vaginal deliveries; (2) the woman experiences a very long labour, allowing her perineum to have an opportunity to stretch sufficiently; or (c) the woman’s doctor or birthing midwife thinks it is unnecessary.

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Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
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21 comments

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  • Mjhe bas itna bta do.. ye sb sun kr k krte ho ya mar dete ho insan ko jeete jee aise sui chala k.. salo ek br me hi mar do.. ye sare dukh ldkio ko hi de diye

  • everyone calm down �� I justt had my baby last week and I had a SECOND degree tear and it did not hurt a bit! I had the epidural which also didnt hurt and also as soon as i could walk i was just a bit sore but even when i peed it did not sting now I can wipe normally and run and do my normal excerises honestly nothing to be afraid of ����

  • I had a fourth degree but my stitches broke an got a very bad blood infection and I pushed for 2 hrs. My sons head was out but shoulders got stuck “ shoulder dystocia.” I dint feel back to normal for a year. I definitely had to do use tucks pads.

  • I gone through this but now the problem is this they are not healing it’s my 10 day I still feel severe pain help me what should I do?

  • This makes me want to cry bc I think I have a tear but I don’t know how bad it is and this looks painful hopefully they give me the gas to put me asleep bc there is no fcking way I am going to stay awake while they fix me this makes me wanna cry it scares the hell outta me���� I’m getting really scared and nervous and sad all at the same time I just want this over with! I keep bleeding and it not stopping and it makes me worry what if I end up not being able to have kids!�� (sorry as you can tell I’m really freaked out and scared)

  • I also had an episiotomy which resulted in a 4th degree tear as my daughters heart rate dropped. I don’t feel like i have healed completely I still have some muscle weakness, i am going to start physio soon so hopefully that will help!

  • I promise whenever my son give me an attitude when he become a teenager i will show him this. I had catastrophic tear when i gave him birth its still uneasy for me to realize i went thru this all. Crazy.

  • My fiance was in labor for 24hrs after being induced on june 30, 2019 @ 8pm until she had a very hard time with the pain until they gave her the epidural at 4am amd she was still not dilated at all when they gave it to her amd they didn’t know her spine was curved so the epidural only numbed one side of her body then they would give her syringes full of epidural meds amd she would rest and dilate for about 2 hrs then the pain was back, that happened 3 times before they removed amd replaced the epidural amd then baby girl was born a couple hours later on july 1, 2019 @ 8:02pm, she had a 2nd degree tear and I felt so bad for her while they were stitching her up, it took a good long time for her to heal..I had to help her go to the bathroom amd spray her off and get her pads ready…I can only imagine what you went through she could hardly move amd she couldnt do the baths either, I just got her witch hazel amd some spray stuff amd put pads in the fridge amd freezer to be cold

  • I found your videos after suffering a 4th degree tear myself a year ago. You were so comforting to watch and I’m so glad that you’re willing to speak openly about it. It makes all the difference in the world!

  • Oxford wrote up the method of ‘birth canal widening’ to 10cm diameter prior to birth; and ‘Anibal’ and ‘EPI-NO Delphine Plus’ birth trainers, make the need to cut totally avoidable. Please view ‘Opening Doors for Baby to 10cm’ on YouTube for the painless alternative to cutting.

  • I still don’t whether I had a tear or it was an episiotomy, i had a 2nd degree, and it took forever to heal!! Months for sure. I totally feel you about sitting on the toilet situation…

  • Atleast use an episiotomy scissor if you’re making a sialistic educational video about it. That’s a suture cutting scissor you’re using!

  • I had a second degree tear.. it was pretty bad, and it took them almost 45minutes to stitch me back up… My vagina looks so different now smh ����

  • Doctors in rush to move on to other patients. Doctors and hospital staff laung and smile on there face when they cut episiotomy then baby delivery. Doctors and hospital staff always ask female patient and partner would like extra stiches put in side of female patient vagina area so she has tigher vagina area to please partner with sex and painful intercourse for female patient. Called daddy stiches

  • So I opted for a c-section, for a multitude of reasons, but I just new that was going to be the best decision for me. My delivery was amazing. We scheduled our day, went in, no stress, no drama. Baby was out in like 15 min and I was in recovery within the hour. My recovery was awesome. By day 5 I was 80% and by my 1 week check up I was completely feeling like myself again. Obviously there are some restrictions up until 6 weeks postpartum but I did a 3 mile hike at 13 days postpartum no problem. My scar is basically invisible and most importantly I have a happy healthy baby girl. I think the stigma around a c section is crazy. I’m my opinion it’s just as great an option as a vaginal birth. I say this because I’ve followed you from before Hugo was born and I know you had a really horrible experience with vaginal delivery.

  • Not gonna lie, that whole process sounds pretty brutal and just as rough as a c-section. My mom had a c-section with my sister and then the sam exact situation with the episiotomy and tearing when she had me. It’s insane what women go through to have their babies! You’re a strong badass mama����❤️

  • This is why I’m going to get a surrogate mother to carry my child instead of giving birth because I could NEVER IMAGINE THE MENTAL STRENGTH ��. Shoutout to all the women who do though! But I’d literally kms

  • I had an emergency C-section with my son and it sounds like your recovery was worse then mine! Most importantly we have healthy little boys.

  • no episiotomy here but soon having a skin bridge removed with this sort of block and nervous. Just need it done though as it is affecting my comfort ( the bridge is always pulling on both cheeks) not to mention it being a hygeine hazard. Just will be glad to have it gone.

  • Damn it…why this happend to women..why we can not just give birth to a very small baby like kangoro, and then he will grow up as magic after…

  • Hi like video on daddies stiches. My wife had bady year ago and had daddies stiches put in and has pain when having sex. Physical therapy said try dildo to stretch your vagina bigger. Ok. Have wife do not play with herself. Mite be lololo at this. Obgyn was teaching her breast feed and found lump in her one of her breast. 9 months ago she had mastectomy to remove one breast. Breast cancer doctor told her if she was doing self breast exam on self she would found it then obgyn doctor. My point get across is females should be getting know there body try things out when they get daddies stiches. Dildo working great. Thanks