With about 7.6 billion world population, 49% comprises of women or about 3.7 billion. As per Sound Vision, there are about 2 billion mothers in the world, and about 4.3 babies born every second. Imagine how many minds have been thrilled or maybe tormented with giving birth, as not all deliveries or childbirths are the same. It could depend on the baby’s size and the mother’s body. Some smooth experience childbirth, according to a healthcare provider, while some suffer a traumatic moment to the point of near-death.
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What Is Episiotomy?
In obstetrics and gynecology, an episiotomy is the artificial widening or cutting of the area between the vagina and the anus using surgical scissors or a scalpel. This area is called the perineum. This is done to accommodate the size of the head or when the baby is breech to avoid perineal tears. The midwife or healthcare provider slits the perineum or the area between the vagina and the anus to create a wider opening for the baby.
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It was in 1742 when Sir Fielding Ould first performed episiotomy as he described the head to be stuck in the perineum and could not come out. However, the healthcare provider clearly stated that the surgical procedure should only be performed as a last resort or in cases of emergency where the lives of either the mother or the baby are at risk.
What Are The Two Types Of Episiotomy?
Midline Or Median Incision
Midline incision or median incision is a vertical slit or cut. Not just one healthcare provider said this is the easiest to restore, but the downside of this is there is a higher chance of cutting down into the anus.
Mediolateral Incision
A mediolateral incision is an angled or diagonal slit or cut. A mediolateral episiotomy could be more painful, but it would avoid extending the cut down into the anus.
What Are The Causes Of Episiotomy?
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- When the healthcare provider sees there is a possibility of a vaginal tear which is 95% of the time, especially for new moms
- When the baby is large, and the vaginal opening is too small
- When the baby isn’t getting enough oxygen
- When the baby is in a breech position or when the lower extremities are first to come out
- When the baby’s head is in an abnormal position or when it tilts to the incorrect side
- When the baby’s life or yours is at risk, and there needs to be an emergency delivery
- When expecting twins or more, a vaginal cut provides more space for giving birth to the next baby
- When there was a previous pelvic surgery as this could damage the repair
What Are The Complications Of Having the Procedure?
There is a risk of infection after an episiotomy
The risk of inflammation after an episiotomy
The risk of hematoma or the accumulation of blood at the area
The risk of bleeding after an episiotomy
Many become afraid of having sexual intercourse after an episiotomy
The pain of having sexual intercourse after an episiotomy
Aftercare Of Episiotomy:
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- Use of antibiotics to prevent infections
- Use of pain relievers to reduce pain and discomfort
- Use of stool softener to aid in smooth bowel movements
- Use of medicated pads
- Use of a bidet instead of toilet paper when cleaning
- Use of squirt bottle instead of solid soaps
- Application of cold packs to numb the perineum area
When To Call The Doctor:
- When you have foul-smelling discharge from the episiotomy site
- When you experience bleeding from the episiotomy site
- When you experience perineal pain
- When you experience signs of infection such as fever, pain, or swelling at the incision site that does not improve
- When pain medications do not seem to take effect
- When you experience trouble controlling your bowels or bladder
Episiotomy sounds to be a nightmare, a part of the magical moment of childbirth which most mothers prefer not to talk about. If you are about to give birth and do not want to have the cut, you should choose a doctor who doesn’t perform episiotomies.
Also, it would help if you make your objection clear. Labor and childbirth are already traumatically painful as they are. So when there is a way you can avoid experiencing further suffering brought by episiotomy, make the decision to prevent the unnecessary cut.
Take Away
The procedure known as episiotomy has been extensively reviewed by authoritative bodies such as the American College and examined in systematic reviews, including those in the Cochrane Database. This surgical incision is made to relieve pressure and assist when a baby needs to be born quickly or delivered quickly, potentially reducing the risk of severe lacerations or third degree tears that can extend to the rectum, leading to issues like fecal incontinence.
However, episiotomy makes the postpartum healing process crucial. Effective healing practices include the use of warm water to cleanse the area, and water-based lubricant can ease discomfort during recovery. Women may experience a smelly discharge and discomfort for a few weeks post-procedure, which is normal but requires monitoring for signs of infection or complications.
Pelvic floor exercises are highly recommended postpartum to strengthen the area and aid in recovery, potentially mitigating long-term effects like incontinence. Research and guidelines from institutions like the National Institute of Health underscore the importance of considering episiotomy only when medically necessary, as the trend towards minimizing routine use is supported by evidence pointing to natural tearing and its healing outcomes.
In conclusion, while an episiotomy can be a valuable intervention to relieve pressure and ensure a child is born quickly, it comes with considerations for postpartum recovery and the potential for complications such as fecal incontinence. Adhering to recommended care practices, including pelvic floor exercises and the judicious use of episiotomy, can support better healing outcomes and overall maternal health.
Frequently Asked Questions (FAQs):
What Is An Episiotomy?
An episiotomy is an incision in the area between the vagina and anal sphincter. Routine episiotomies expand the opening of the vagina to prevent the vaginal tissue from going through natural tearing during the delivery. There are different levels of possible tearing, with fourth degree tearing being the most extreme. Read further here: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/episiotomy
Is It Okay To Have Episiotomies?
American healthcare providers widely believe that an episiotomy heals better than a natural or spontaneous perineal tear. However, there are some instances when it may cause more problems than it prevents, particularly if you need more than a midline incision. You have to talk about it with your healthcare provider during the second stage of your prenatal visits.
How Do You Care For Episiotomies?
You can use pain relievers for that. These include ibuprofen, medicated creams, and local anesthetic sprays, to ease the pain from an episiotomy. Your healthcare provider will discuss different techniques to help you heal as soon as possible.
Can Episiotomies Tear Again?
It may take time to repair the tears in surgery, and it may take several months to recover from it fully. But a lot of women who have another vaginal delivery will not have a severe tear again.
Can Episiotomy Stitches Reopen?
Sometimes episiotomy stitches do not just come undone, according to a healthcare provider. But occasionally pressure or an infection on the stitches can cause the sutures to break down. Thus, it leaves an open or gaping wound.
What Are The Risks Of Episiotomies?
A healthcare provider said that the higher risk of vaginal opening issues include tearing, bleeding, swelling, infection, and pain during sex.
What Is The Fastest Way To Heal Episiotomies?
You can cure midline episiotomy or midline incision by using ice pack and sitz baths on your vaginal opening, as well as changing your pads every 2 to 4 hours. Just keep the area of the stitches dry and clean.
Why Would Doctors Give Episiotomies?
You need an episiotomy to prevent more extensive vaginal tears during a woman’s childbirth (vaginal birth or normal labor, that is). Routine episiotomies also help preserve the connective and muscular tissue support of the pelvic floor and avoid fetal distress and shoulder dystocia in the second stage of labor.
How Do You Poop After An Episiotomy?
One of the perineal techniques is to make it less painful on the vaginal opening stitches or natural tear by using a sanitary pad that is folded. Pressed against your vagina or perineal skin while straining with your anal sphincter muscle. Wipe from front to back to ensure your stitches are clean.
What Should You NOT Do After The Procedure?
First, patients should abstain from sexual intercourse until the episiotomy completely heals. That’s surgical incision does not help on reducing perineal trauma on your vaginal tissues and sphincter muscle, so you shouldn’t stress it out further to ease soreness and reduce swelling and higher risk of opening up your stitches. Also, avoid douching and using tampons.
Can Episiotomy Stitches Get Infected?
Infection is possible as with all surgical procedures. If you experience severe pain at the incision site, and there’s redness and swelling around the stitches, call your doctor immediately.
How Long Will It Take For An Episiotomy Scar To Heal?
Usually, it is within ten days. It shouldn’t take more than a month.
Do Episiotomy Stitches Bleed?
Yes, the episiotomy incision has a high risk of bleeding quite a bit at first. But it should stop once your doctor closes the wound with sutures.
Is It Normal For Episiotomy Scars To Hurt?
Yes, scar tissue can develop after episiotomy and has a high risk of causing intense pain if it gets irritated, especially if you have fresh episiotomy incisions, even if you take over-the-counter medication.
When Can I Take A Bath After An Episiotomy?
What Is An Episiotomy Incision, And When Is It Performed During A Vaginal Birth?
How Is An Episiotomy Incision Different From Other Types Of Surgical Incision Used In Childbirth?
What Are The Risks And Benefits Of Having An Episiotomy Incision During A Vaginal Birth?
Last Updated on May 9, 2023 by Cath Aguinaldo
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