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Is Episiotomy necessary in normal delivery?

It is a small cut made into the perineum (the area between the vagina and the rectum) to widen the vaginal opening. Episiotomies are performed to make it easier for the baby’s head to pass through for delivery and make delivery easier or to prevent tearing of the vaginal tissue.

The majority of women don’t have an episiotomy. Episiotomies were performed to prevent spontaneous tearing of the perineum and to reduce the risk of fetal birth trauma. But these days, studies have shown that infants fare just fine without an episiotomy, mother too.

There are 3 types of episiotomy: 

  • ​​Midline : In a midline episiotomy, the incision is made in the middle of the vaginal opening, straight down toward the anus
  • Medio-lateral: In a mediolateral episiotomy, the incision begins in the middle of the vaginal opening and extends down toward the buttocks at a 45-degree angle.
  • J-shaped episiotomy: the skin of the perineum is cut vertically downwards before being directed to the left or right. 


When it is needed

  • In another challenging birth position. 
  • When your baby is very large and needs a roomier exit route
  • When forceps or possibly vacuum extraction needs to be used
  • The baby is showing signs of distress.
  • It is your first pregnancy.
  • You’ve had previous perineal surgery or injury


Preventive measure

  • Perineal massage can reduce the need for an episiotomy. When the baby comes out, the perineum is more likely to stretch than tear.
  • Practice Kegel exercises.
  • Promote healthy perineal tissue.
  • Push for only five to seven seconds at a time and bearing down gently.
  • Use warm compresses on the perineum