Picture of female vulva side cutting

An episiotomy is a procedure in which an oblique incision is made in the vulva. Episiotomy not only includes lateral incisions, but also medial incisions. It can prevent perineal tears in pregnant women, protect the pelvic floor muscles, and the surgical incision is easy to repair and heal better. The total length of a woman's vagina is 8-9 centimeters. The upper part of the vagina surrounds the cervix, and the lower part opens to the back side of the vaginal vestibule. The front wall is adjacent to the bladder and urethral opening, and the back wall is close to the duodenum.

The vaginal wall has three layers: the inner layer is a mucous membrane with many folds, under which there are rich elastic fibers, muscle tissue and capillaries; the middle and upper layers are muscles, which are spirally and overlappingly distributed; the surface layer is an elastic outer membrane. Although these physiological characteristics of the vagina are very beneficial to the delivery of the fetus, when the fetal head and embryo with a diameter of 10 cm are delivered from the pregnant woman's vagina, if there is no midwife to protect the pregnant woman's perineum, the pregnant woman's perineum will be torn to varying degrees, and in severe cases, complications such as uterine prolapse and urinary incontinence may occur. This will not only affect the rehabilitation treatment of pregnant women, but also their future married life.

When a pregnant woman's perineum is torn, the edges of the wound are very uneven. Not only will it increase the time it takes for the pregnant woman's perineum wound to heal, but it will also easily cause scars after the wound heals, causing discomfort when the pregnant woman has sex after giving birth. Therefore, if an episiotomy can be performed immediately during childbirth, the above-mentioned situation can be avoided. Therefore, when a pregnant woman gives birth naturally, even if she chooses a vaginal birth, the midwife will usually make an incision on the "lower body" of the pregnant woman. Midwives should perform episiotomies especially in the following situations:

1. If the elasticity of the vulva of a pregnant woman is weak, the vagina is narrow, or there is inflammation or edema in the vulva, an episiotomy is required.

2. When the fetus is very large, the fetal head is in a crooked position, or the pregnant woman has insufficient labor force, the fetal head may be blocked at the perineum of the pregnant woman and cannot be delivered. At this time, an episiotomy is needed (if the fetal head waits in the birth canal for too long, it will not only damage the muscles of the pregnant woman's pelvic floor, but will also cause the fetus to suffer from lack of oxygen and even intracranial hemorrhage).

3. For first-time mothers over 35 years old, or pregnant women with heart disease or pregnancy-induced hypertension, in order to reduce the energy consumption of the pregnant woman, shorten the delivery process, and ensure the safety of maternal and child products, an episiotomy should be performed when the fetal head is lowered to the pregnant woman's vulva.

4. When the pregnant woman's cervix is ​​fully dilated and the fetal head is in a low position, but the fetus shows abnormal changes, such as the fetal heart rate is too fast or too slow, the amniotic fluid is turbid or even mixed with the fetal excrement, it indicates that the fetus has obvious symptoms of hypoxia. At this time, because the pregnant woman needs to complete the delivery as soon as possible, a perineal episiotomy should be performed.

5. When abnormalities are found in pregnant women during labor and forceps delivery or vacuum extraction of the fetal head is required, episiotomy must be performed according to the basic rules.

Some pregnant women worry that after an episiotomy, the nerves in the female vagina will be damaged, the suture threads used in the operation will remain in the female vagina, and the vagina will become looser and looser, which will affect the couple's life after giving birth. In fact, there is absolutely no need to worry about this. An episiotomy is a 3 cm long incision made at the vaginal opening (equivalent to the area around 5 o'clock on a digital clock). Such a small wound, if sutured immediately by surgery, will heal quickly.