Episiotomy: What Is It and Why Is It Done?

An episiotomy is a surgical incision into the perineal tissue during the second stage of delivery. It was originally developed by doctors to “prevent perineal trauma, improve pelvic floor functioning, enhance sexual functioning, and prevent the pelvic floor from relaxation” ¹. Williams Obstetrics (the text by which all OB’s learn) states the purported benefits for episiotomy: “It substitutes a straight, neat surgical incision for a ragged laceration that otherwise frequently results and is easier to repair and heals better than a tear” ². Lacerations (whether a spontaneous tear, an episiotomy or an extension of an episiotomy) are categorized in degrees: first degree is skin only, second degree is skin and muscle (fascia), third degree goes from skin and fascia into the external rectal sphincter (partial) and fourth degree goes completely through the rectal sphincter and into the rectal mucosa. But women have been voicing that episiotomies aren’t giving them the benefits cited above and are reporting more than the purported risks of episiotomies: excessive blood loss, hematoma formation (localized collection of blood) and potentially fatal infections ². In addition, women are often not given a choice as to whether or not it’s performed on them. (more…)