Episiotomy and Pregnancy

An episiotomy is a procedure where the skin (the perineum) between the vagina and the anus is cut. It is done occasionally to enlarge the vaginal opening so that a baby can be more easily delivered and so that the tissue below your vagina will not tear.



When your baby's head is stretching the opening of your vagina, your health care provider may perform an episiotomy by numbing your perineum with an anesthetic and then make an incision into this tissue located between the opening of your vagina and your rectum.  This can help prevent the tissue from tearing and a surgical cut is easier to stitch than is a tissue tear. After you deliver your baby, the health care provider will stitch the incision. 

An episiotomy may be advisable if:

  • there is any sign of fetal distress while your baby is in the birth canal

  • a delivery occurs too quickly for the vagina to stretch naturally

  • the baby's head is too large for the vaginal opening

  • the baby's shoulders are stuck

  • you have an unusually narrow birth canal

  • it the baby is being born breech (feet or buttocks coming first) or

  • if forceps are needed to assist in the baby's delivery

Episiotomies were once routinely performed to prevent vaginal tears during delivery.  Currently there remains controversy regarding the procedure and whether or not it should be performed since some women experience prolonged pain with sexual intercourse after pregnancy and other risks including the possibility of infection, bleeding and problems with incontinence.  You should make sure to discuss this with your health care provider prior to delivery as part of your birth plan.

Additional Information

Wikipedia: What is an episiotomy?

National Institutes of Health: Episiotomy


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