An episiotomy involves opening the perineum of the pregnant woman atchildbirth. It is a surgical procedure which allows the child to pass more easily and avoid a spontaneous peritoneal tear.
80% of women in France have an episiotomy in their first childbirth (the term primiparous is used for women with their first pregnancy and multiparous for women who have already given birth).
Indications for episiotomy
An episiotomy can be performed for different reasons:
- to shorten the time needed for the baby to come out, which can reduce the risk of foetal distress in an at risk baby (premature baby, umbilical cord rolled around the baby's neck);
- to prevent the risk of organ descent (known as prolapse) or urinary incontinence;
- to assist expression of the baby in women who have put on too much weight, who have oedema or who have a very short perineum (less than 1 cm between the vulva and the anus).
The different types of episiotomy
There are two types of episiotomy: midline or medio-lateral:
- the midline episiotomy is an incision made at the fourchette of the vulva directly towards the anus extending over approximately 4 cm;
- the medio-lateral episiotomy is an incision which begins at the median part of the apex of the vulva made towards the ischial region extending over an average of 6 cm. This is the most widely performed type in France.
Infections of the peritoneum may develop after an episiotomy. Defecation problems may develop. Sexual intercourse may be painful.
Medio-lateral episiotomy. © Padawane, Wikipedia DP