An episiotomy is a surgical incision made in the perineum, the area between the vaginal opening and the anus, during childbirth to enlarge the vaginal opening for delivery. It is performed to facilitate difficult births, especially if there is a risk of tearing or when the baby needs to be delivered quickly. Episiotomies are sometimes done in cases where the baby is large, in distress, or in an abnormal position, or when forceps or vacuum extraction is used. The goal is to prevent severe perineal tearing, which could be more complicated to repair. While episiotomies were once routinely performed, modern obstetric practice now favors natural tearing over routine episiotomy due to the potential complications associated with the procedure. These include infection, excessive bleeding, and extended healing time. The incision can lead to discomfort, pain during intercourse, and difficulties with urination or bowel movements. In some cases, the episiotomy may extend into a more severe tear, involving the muscles around the anus, leading to long-term complications such as incontinence. Although the procedure is generally safe, recovery can take several weeks, and proper care is required to prevent infection. Regular monitoring and hygiene are important to ensure healing. In modern practice, episiotomies are only performed when absolutely necessary, as evidence suggests that natural tears heal better with fewer complications compared to a surgical incision. However, when needed, an episiotomy can be crucial in ensuring a safe and quick delivery for both mother and baby.
