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Episiotomy is a procedure in which the skin between the vagina and anus is cut. (This area is called the perineum.) Episiotomy is done occasionally to enlarge the vaginal opening so that a baby can be more easily delivered.
Just before the baby is born, the obstetrician numbs the vaginal area opening and makes one of two cuts:
The cut makes the opening to the vagina bigger. The cut is stitched closed after the baby and placenta have been delivered.
Episiotomies were once routinely performed to prevent vaginal tears during delivery. Today, routine episiotomies are not recommended.
However, episiotomies may still be performed when there is a complicated delivery. An episiotomy may be needed if the baby's head or shoulders are too big for the mother's vaginal opening, or the baby is in a breech position (feet or buttocks coming first) and there is a problem during delivery.
It may also be needed to speed the delivery process if there is concern about the baby's heart rate.
Hartmann K, Viswanathan M, Palmieri R, Gartlehner G, Thorp J Jr, Lohr KN. Outcomes of routine episiotomy: a systematic review. JAMA. 2005;293(17):2141-2148.
American College of Obstetricians-Gynecologists. Episiotomy. Clinical Management Guidelines for Obstetrician-Gynecologists. ACOG Practice Bulletin. 2006;71.
Carroli G, Mignini L. Episiotomy for vaginal birth. Cochrane Database of Systematic Reviews. 2009;1:CD000081.
Frankman EA, Wang L, Bunker CH, Lowder JL. Episiotomy in the United States: has anything changed? Am J Obstet Gynecol. 2009;200:573.e1-573.e7.
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