GIVING birth can be stressful and some women might need assistance in the form of a episiotomy.
It’s a procedure which involves a cut made at the opening of the vagina – which can sound daunting for pregnant women.
An episiotomy helps aid difficult delivery and prevents the rupture of tissue.
Posting to Instagram, one expert revealed what the procedure actually looks like and when it should be used.
First aider and CEO of parenting organisation Tiny Hearts Education, Nikki Jurcutz, said the procedure is carried out using specialised sharp scissors.
She explained: “Episiotomies are performed to prevent severe damage to a mama’s perineum, bottom or anterior compartment [the area where the urethra and clitoris is].
“That’s because severe tears may significantly impact her future birthing and sexual experiences, depending on the location and severity of the tear.”
It’s a procedure that isn’t routinely recommended and there are some special circumstances as to when it can be performed.
Nikki said that one of the main reasons for a episiotomy is when a mum is having a vacuum or forceps birth.
The NHS states that this is known as assisted delivery and will only be used when it’s necessary for you and your baby.
Assisted births are needed in around one to eight births and may be carried out if you’ve been told you can’t push hard due to issues such as high blood pressure.
You might also have an assisted birth if there are concerns about your baby’s heart rate or if the baby is in an awkward position.
Nikki added that a episiotomy may be performed if the mum’s vaginal area is showing signs of significant stress, such as ‘button-holing’.
Button-holing is a tear which can create a hole between the bowel and the vagina – it’s a rare condition that can result from vaginal childbirth.
You might also need a episiotomy, Nikki said, if the baby is getting stressed and needs to be born immediately, as this will speed up the birth.
If you’re having a shoulder dystocia, where baby’s shoulder is stuck on your pelvic bone, then you might also need a episiotomy.
Prior to cutting an episiotomy, Nikki said a doctor or midwife should inject your perineum with a local anaesthetic to numb the area to ensure you don’t feel the cut.
She explained: “An episiotomy can only be cut with your consent, so it’s important to have a discussion with your care provider beforehand about circumstances in which you do and don’t consent because it can be easy to say yes or no in the heat of the moment without really thinking about it.
“Generally, episiotomies are cut on a mama’s right-hand size, on an angle between 30-60 degrees.
“That’s because if a cut is made straight down towards the bottom, there’s a risk that it may extend into the bottom. It’s also important to know that episiotomies aren’t foolproof.
“This means that just because you’ve had an episiotomy, it doesn’t mean that you won’t sustain any other type of trauma to the area as well.”
She added that if you do have a episiotomy, then it will be stitched up after birth.
Once you arrive home from the hospital, Nikki said you should keep the area clean and dry and watch out for signs of infection.
She highlighted that you should change your pad regularly and keep up the pain relief so that you aren’t left in severe discomfort.
Midwife Lesley Gilchrist previously highlighted that you shouldn’t be afraid of taking pain medication after you have given birth.
“Usually pain will peak at around day three and you can take regular painkillers every four to six hours – but no more than eight in 24 hours.
“You should check if you are able to take ibuprofen and if you can, stagger those too.
“Take them even if you think you don’t need them as it’s hard to get on top of the pain.
“If you’re in pain then you can’t sleep and your body needs that time to recover. A lack of sleep is bad for your mental health so it’s really important to keep on top of it.”
Lesley said that you will usually heal up nicely on your own, and that if you have had a fast labour you are much less likely to develop an infection.
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