Episiotomy

From Encyclopedia of Sex and Sexuality

An incision made in the perineum (the area between the vagina and the anus) in order to enlarge the area of the vaginal outlet and facilitate delivery during childbirth. The most common form of episiotomy is in the midline, from the rear part of the vagina in a direction toward the anus. Occasionally this incision is made at a 45 degree angle and is termed mediolateral, as opposed to a median or midline episiotomy. There is general agreement that an episiotomy is called for in cases in which the fetus’s descent is delayed or as an aid to some forceps or vacuum deliveries.

The role of episiotomy as a routine procedure in normal deliveries is debated. Advantages include substitution of a straight surgical incision for a ragged laceration of the mother’s tissues and reduction of trauma to the musculature of the pelvic floor. Recent evidence indicates that severe lacerations are more common in patients who have had episiotomies than when episiotomy was not performed. The disadvantages of episiotomy include increased blood loss from the incision and the possibility of an increase in trauma over that which would have occurred spontaneously. The debate is, as yet, unresolved.