Pregnant woman posting episiotomy photos

The perineum refers to the soft tissue area between the vagina and the anus. When the baby's head is about to appear outside the vulva, the doctor will give local anesthesia around the perineum, and then use scissors to cut the perineum to make the birth opening larger, so as to facilitate the birth of the baby and avoid severe tearing of the perineum. This is the so-called episiotomy.

Is episiotomy necessary?

Faced with episiotomy, many pregnant women are full of concerns. Many people expressed that they don’t understand and think they don’t need an episiotomy. Some even think that the doctor made an extra cut for their convenience. Is an episiotomy really necessary? In what situations is an episiotomy necessary and in what situations is it not necessary?

When the doctor sees that the fetal head is about to expose the vulva, he will assess whether the perineum will be severely torn during delivery based on the elasticity and height of the perineum; assess whether the fetus is hypoxic and needs to be delivered as soon as possible, and then decide whether an episiotomy is needed; if the doctor judges that the fetus is in good condition, the elasticity of the perineum is very good, the delivery process will be smooth, and even if the perineum is not cut, the tear wound will not be large, then surgery can be avoided.

Pregnant women in the following 6 situations must have an episiotomy:

1. During delivery, the perineum of a primipara with head presentation is too tight, the perineum is long, the tissue is hard or underdeveloped, there is inflammation or edema, or the perineum cannot be fully expanded during emergency delivery. It is estimated that shallow perineum laceration will occur when the fetus is delivered in head presentation.

2. Pregnant women whose fetuses have cephalopelvic disproportion due to various reasons.

3. Pregnant women who have undergone perineal incision and suture surgery, or have large scars after repair and poor elasticity that affect the expansion of the perineum.

4. Pregnant women who are specialized in forceps delivery, vacuum delivery for fetal head presentation, or first-time breech presentation who are having a natural delivery.

5. Premature babies, fetuses with intrauterine language retardation or fetal distress, in order to prevent the fetus from being squeezed in the birth canal for too long, causing severe fetal asphyxiation or intracranial hemorrhage.

6. If you suffer from heart disease, high blood pressure, liver disease or severe myopia, etc., in order to relieve the pressure of childbirth for pregnant mothers, you need to deliver the fetus as soon as possible.