Are Episiotomies Safe?

What is an Episiotomy?

An episiotomy is a surgical procedure used to make the opening of the vagina wider to help make the delivery process easier. When an episiotomy is done properly, the procedure typically poses no imminent problems to the mother or baby. However, in some instances, complications can arise. Read on to learn more about when an episiotomy is appropriate and the risks involved with this surgical procedure.

When is an Episiotomy Necessary?

Episiotomies have been performed by doctors delivering babies for decades around the world. Episiotomies were first recommended in the 1920s to protect a woman’s pelvic floor from tears and a baby’s head from trauma. However, research suggests that it may not prevent these problems from occurring. In 2006, The American College of Obstetricians and Gynecologists (ACOG) made a recommendation against using this procedure. The ACOG recommends that an episiotomy should be performed based on clinical judgment and assessed conditions of the mother and baby.

When a baby must be delivered quickly, an episiotomy may be necessary under the following conditions:

  • Shoulder dystocia is present (a baby’s shoulder is stuck behind the pelvic bone).
  • The baby has an abnormal heart rate during delivery.
  • The mother needs birth assistance through forceps or vacuum extraction.

What are the Risks of an Episiotomy?

The following risks are associated with episiotomies:

  • Infection
  • Pain during intercourse
  • Fourth-degree vaginal tearing (tears from the anus to the mucous membrane that lines the rectum)
  • Fecal incontinence

Long term effects of this procedure may include:

  • Chronic pain
  • Chronic infections
  • Anorectal dysfunction

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