What does episiotomy mean?

For many pregnant women, episiotomy during normal delivery is like a knife hanging over their heads. Some would even choose cesarean section rather than episiotomy. There are many "rumors" about episiotomy during normal delivery. Some people say that the episiotomy wound will affect the couple's life, and some people say that the episiotomy wound will cause postpartum urinary incontinence. Is there any scientific evidence for this?

What is episiotomy for normal delivery?

Episiotomy during normal delivery can definitely make pregnant mothers pale in an instant, but in fact, it is a defensive surgical treatment. In order to avoid excessive damage to the mother's birth canal and private parts during the delivery of the baby, the doctor will first cut the vulva under local anesthesia.

How painful is episiotomy during vaginal delivery?

When mothers think of the episiotomy wound in their private parts, they seem to feel the pain immediately, but in fact, compared with the pain during childbirth, the pain of the episiotomy wound can be basically ignored. In addition, when performing episiotomy, doctors will generally perform local anesthesia in advance. For pregnant women with poor pain tolerance, they can ask the doctor to increase the amount of anesthetic appropriately. Pregnant mothers should be reminded that generally speaking, the pain of episiotomy during normal delivery is mostly reflected in the suture stage after a successful delivery. The pain at this time is more severe than the episiotomy wound itself.

What is the whole process of episiotomy during normal delivery?

The doctor pointed out that there are two ways to perform episiotomy for normal delivery for mothers. One is to make a cut in the middle, and the specific method is to start from the bottom of the vulva and make a vertical cut downwards. This is a common method when only a small amount needs to be cut. A median incision may damage the external anal sphincter and even the duodenum and is generally less used. The other is a side incision, where the doctor will make an incision at a 45° angle from the bottom of the vulva. Episiotomy is often used in clinical medicine, which is also beneficial for vaginal dilation surgery and will not injure the duodenum due to increased incision. Its disadvantages are heavy bleeding at the site of tissue incision and severe pain after the operation.

What situations require episiotomy during childbirth?

Pregnant mothers generally have a misunderstanding that almost all natural births require an episiotomy. Some news media even claim that the episiotomy rate for natural births in my country has reached 99%. But the actual situation is that not all pregnant women who choose natural delivery need episiotomy. Doctors should make an episiotomy based on the different physical conditions of each pregnant woman and her own ability to adapt and adjust. Some new mothers will feel pain for a few days after giving birth, while some new mothers will feel pain for a month or even longer.

Generally speaking, pregnant women giving birth to their first child are more likely to have episiotomy wounds. This is because the perineum of first-time pregnant women with head presentation is too tight during delivery. In addition, some pregnant women have long perineum, hard or underdeveloped tissue, inflammation, edema, or the perineum cannot expand sufficiently during emergency delivery. It is estimated that grade II or above lacerations will occur during delivery of the fetus in head presentation, and these are all prescribed episiotomy wounds by doctors.