Episiotomy

Episiotomy is the procedure of enlarging the vaginal opening to accomodate the birth of the baby. With an episiotomy, a doctor or midwife cuts the perineum as the fetal head is about to be born. The perineum is the tissue between the opening of the vagina and the anus. As the baby’s head is about to be born, the perineum flattens out and cut be cut easily with surgical scissors. Episiotomy is the second most common surgical procedure in the U.S……second only to circumcision. And the topic is right up there with circumcision as far as controversy goes. The camps are divided on whether routine episiotomy is a good or bad thing.

Those in favor of routine episiotomy claim that the procedure prevents structural damage to the supportive tissues of the vagina, bladder and rectum. They claim that the wound created is preferable to the lacerations which can occur when an episiotomy is not performed. They claim that an episiotomy is easier to repair than a “ragged” laceration.

Those who disagree state that routine episiotomy subjects a mother to damage to the rectal muscle, infection, and unnecessary pain. To this camp, routine episiotomy is the poster child to all that wrong with the “medical model” of childbirth.

Here’s the scoop based on science:

  • Episiotomies are more painful than lacerations during the healing process.
  • It is still unclear if performing episiotomy protects against or predisposes to structural problems of the vagina or bladder.
  • It is still unclear if not performing episiotomy protects against or predisposes to structural problems of the vagina or bladder.
  • Episiotomies which extend into the rectal muscle predispose to rectal structural problems.
  • Disruption of the rectal muscle is many times more common when episiotomy is performed.
  • Episiotomies are easier to repair.
  • If an episiotomy is done, there will be a wound.
  • If an episiotomy is not done, there will be a wound about 50% of the time.

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