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An episiotomy is a surgical procedure that enlarges the vaginal opening during labor by cutting the perineum, the skin and muscles between the vulva and anus, wrote University of Maryland Medical Center (UMM).
According to Babycenter.com, episiotomies have been on the decline, from nearly two out of three vaginal births in 1979 to less than one in five in 2004.
For years, an episiotomy was thought to help prevent more extensive vaginal tears during childbirth and heal better than a natural tear, said Mayo Clinic.
The procedure was also believed to keep the bladder from drooping and the rectum from protruding into the vagina after childbirth.
Doctors argued women would feel less postpartum pain and have fewer future problems with pelvic floor complications, added New York Times.
Today, however, research suggests routine episiotomies don't prevent these problems after all.
There is no good evidence that episiotomy offers vaginal tissue and pelvic floor muscles any real protection and the procedure may actually lead to problems, reported Babycenter.com.
New York Times wrote that one study showed women who had episiotomies were as much as six times more likely to report fecal or flatus incontinence than women who delivered with an intact perineum.
Women who get an episiotomy are more likely to end up with a serious tear through the anal sphincter or even all the way through the rectum than those who deliver without being cut, wrote Babycenter.com.
Episiotomies are actually associated with more postoperative pain, said New York Times.
Sometimes the surgical incision is more extensive than a natural tear would have been, cautioned Mayo Clinic.
Women who have an episiotomy tend to lose more blood during delivery, and due to painful scarring, some have to wait longer before having sexual intercourse without discomfort, wrote Babycenter.com.
A recent study showed that getting an episiotomy during a first vaginal birth is linked to an increased risk of tearing in the next birth, said Babycenter.com.
The American Pregnancy Association (APA) wrote that episiotomies have other potential side effects including infection, bruising, swelling and bleeding.
Research has shown that women with a spontaneous tear generally recover in the same or less time and often with fewer complications than those who had an episiotomy, stated Babycenter.com.
The American College of Obstetricians and Gynecologists say that episiotomy "is not always necessary" and "should not be considered routine", reported About.com.
There are conditions when an episiotomy may be needed. New York Times wrote that if a woman has an unusually tight perineum and the tissue just isn’t stretching; if a baby is showing signs of distress during delivery; or if a baby with a very large head may cause a rectal or urethral tear, an episiotomy may be of benefit. APA added that if the mother isn't able to control her pushing she may do better with an episiotomy.
Sources:
"All about episiotomy | BabyCenter." BabyCenter | Homepage - Pregnancy, Baby, Toddler, Kids. N.p., n.d. Web. 30 Jan. 2013.
http://www.babycenter.com/0_episiotomy_165.bc
"Episiotomy: American Pregnancy Association." Promoting Pregnancy Wellness: American Pregnancy Association. N.p., n.d. Web. 30 Jan. 2013.
http://www.americanpregnancy.org/labornbirth/episiotomy.html
"Episiotomy: When it's needed, when it's not - MayoClinic.com." Mayo Clinic. N.p., n.d. Web. 30 Jan. 2013.
http://www.mayoclinic.com/health/episiotomy/HO00064
"Labor and delivery - Episiotomy." University of Maryland Medical Center | Home. N.p., n.d. Web. 30 Jan. 2013.
http://www.umm.edu/pregnancy/000136.htm
Margulis, Jennifer. "What You Don't Know About Episiotomies Can Hurt You - NYTimes.com." Parenting, Children and Parents - Motherlode Blog - NYTimes.com. N.p., n.d. Web. 30 Jan. 2013.
http://parenting.blogs.nytimes.com/2013/01/27/what-you-dont-know-about-episi
Weiss, Robin Elise. "Episiotomy - Do you need one to give birth?" Pregnancy Week by Week Calendar Pregnancy Symptoms and Pregnancy Test. N.p., n.d. Web. 30 Jan. 2013.
http://pregnancy.about.com/cs/episiotomy/a/aa042897.htm
Reviewed January 31, 2013
by Michele Blacksberg RN
Edited by Jody Smith
Keywords: episiotomy, episiotomies, perineum, pelvic floor, tear, during delivery, procedure, birth, natural tear
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