What is an Episiotomy and How Can I Avoid Needing One?

What's an Episiotomy?

An episiotomy is a cut that your doctor makes during labor to widen your vaginal opening. The cut typically goes from your vagina towards your butt. Doctors will typically give moms local anesthesia before to numb the pain.

Episiotomies used to be done routinely because doctors thought that a clean-cut would heal better than a tear. It is now understood that episiotomies are rarely needed. Doctors will still perform them if the baby is in distress and your care provider needs to hurry labor or if the baby’s shoulders get stuck (called shoulder dystocia).

Episiotomy Risks

If you want to reduce your risk of having an episiotomy, the first step is to talk to your care provider. Ask their views on episiotomies, how often they perform them, and what steps they take to avoid them. 

Avoiding an Episiotomy

There are also two things you can do during pregnancy to prepare your vagina for labor and help avoid an episiotomy. During the last month or two before your due date, perform Kegel exercises and perineum massages to strengthen and stretch the muscles of the pelvic floor.

Making Kegels a part of your daily routine can make labor and post-birth recovery easier. Read about how to practise Kegel exercises here. 

Most care providers suggest waiting until around 36 weeks to start perineal massage (it’s always a good idea to check with your doctor before you begin). When you do, make sure your hands are clean and your nails are trimmed. Then take a bit of oil (you can use olive, coconut, or any vegetable-based oil) and massage the bottom of the opening of the vagina. This exercise stretches the tissues little by little to open them up. You may find it easier for your partner to assist you since it can be hard to see with a pregnant belly in your way!

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