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Episiotomy

• Overview
• Recovery
• Risks

Definition:

Episiotomy is a procedure where the skin between the vagina and the anus (the perineum) is cut. It is done occasionally to enlarge the vaginal opening so that a baby can be more easily delivered.

Description:

Just before the baby is born, the obstetrician numbs the vaginal area and makes one of two cuts:

• A mediolateral cut is angled down away from the vagina and into the muscle.
• A midline cut is made straight down between the vagina and anus.

The cut makes the opening to the vagina bigger. The cut is stitched closed after the baby and placenta have been delivered.

Indications:

An episiotomy may be needed if the baby's head is 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.

References:

Hartmann K, Viswanathan M, Palmieri R, Gartlehner G, Thorp J Jr, Lohr KN. Outcomes of routine episiotomy: a systematic review. JAMA . 2005 May 4;293(17):2141-8.

• Review Date: 5/6/2007
• Reviewed By: Rachel A. Lewis, MD, FAAP, Columbia University Pediatric Faculty Practice, New York, NY. Review provided by VeriMed Healthcare Network.

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