An episiotomy is a surgical incision made at the time of child birth in the muscle between the woman’s vagina and rectum to increase the size of the opening through which a baby emerges. This is to assist in the delivery of the baby and to ease its passage.
Women who have not received an epidural are typically given a local anesthetic prior to performing an episiotomy. An episiotomy usually takes between 4 and 6 weeks to heal, depending upon the size of the incision and the kind of suturing done.
An episiotomy has been a controversial subject and in recent times, the incidences of this surgical procedure have gone down since earlier times when episiotomies were often performed without any real requirement.
There are several benefits to having an episiotomy in that it makes it easier for the mother to deliver her baby since there is less pushing for her to do.
The often made argument in favor of episiotomies is that it can trauma to the vaginal tissue and is easier to recover from that spontaneous or accidental tearing of the tissue there, with fewer chances of complications.
If there is any kind of fetal distress or if the baby is in an awkward position, an episiotomy is indicated for a speedier delivery. Also if there is danger of extensive tearing or laceration an episiotomy is recommended.
Earlier it was also believed that episiotomies could prevent incontinence and prevent displacement of the bladder and rectum however it has later been found that routine episiotomies do not prevent this. The argument against routine episiotomies is strong – firstly there is the fact that recovery can be long and uncomfortable; and could mean painful sex for a long time.
There are also several complications that can occur as a result of an episiotomy – there is the danger of infection and delayed or improper healing, since there are chances of improper closure of the wound given the location of the incision.
There also exist possibilities of swelling and bleeding from the area and which can create problems. Short term sexual dysfunction may be noted and many women report that they are unable to have pain free sex for many months after the delivery. According to many experts the risk of developing fecal incontinence is also said to rise with this surgical procedure.
So the bottom line is that episiotomies are not to be performed routinely, they should only be done when there exists an actual medical requirement.