When Is Episiotomy Necessary?

Episiotomy is a surgical slit done in the section of the skin that lies in-between the vagina and the anus – the perineum for enlarging the vaginal opening to facilitate easier emergence of the baby’s head during delivery.

Though, earlier deemed as the norm during child delivery, there is immense disagreement regarding whether episiotomy is helpful  or not – few experts prefer to opt for a perineal slit rather than a cut, and studies do indicate that tears have swifter recuperation rates and have less chances of complications.

Though episiotomies are no more considered an unavoidable practice, one might require to get one – for instance if one is having a large-sized or breech baby, an forceps-aided delivery, a vacuum extraction or the baby might have got trapped in the birth canal.

How are episiotomies carried out?

In case one has not be administered an epidural injection, the perineal part would be de-sensitized by injecting a local anesthesia. The incision might either be done as a midline slit – that is straight down towards and close to the rectum; or a mediolateral slit – that is done in an angle to one of the sides that is away from the rectum. Despite the midline slit being easier to fix and leads to lesser discomfort and pain, doctors still prefer to do the mediolateral slit as it is less prone to causing any kind of damage to the area near the rectum.

Dissolvable stitches are normally used, that do not need one to re-visit the hospital for their removal. The healing time for the stitches is close to a month’s time following child birth. One needs to discuss with the healthcare provider regarding which activities need to be steered clear from during the recuperative phase.

How discomforting or painful can Episiotomy be?

An episiotomy is normally done in the concluding stages of labor and not as painful as the contractions one experiences. The area would be de-sensitized when the procedure is conducted and hence such women don’t seem to sense any pain – factually, some women consider it an immense respite as it facilitates the baby to be born with ease and instantaneously.

Post –procedure Care

A certain level of pain is sensed as soon as the slit has been sutured. There are several ways to allay the pain, namely:

• Kegel Time: Kegel exercises are known to raise blood circulation in the sore spot and aid in speeding up the recovery process.
• Cold Compression: Holding an iced pack against the sutures to reduce the swelling, even a swathed pack of frozen peas would be a good option.
• Sitz Bath: A herbal sitz bath (obtainable at the hospital or medical stores), lavender and even a salt water bath could prove be beneficial soothers. One needs to carefully dry the sutured area by gently patting it with a towel instead of rubbing it. Even a hairdryer set on cool setting could prove effective in drying the stitches.
• Diluting the wee: A great way would be dribbling a cupful of warm water over oneself while peeing and ensuring that one wipes carefully starting from the front side to the back side.
• Taking frequent walks: Walking as much as one can possibly manage to, would help in speeding up the recovery process.
• Ventilating the sutured area: Letting the sutured part to get air – going ‘commando’ for lengthy periods of time would definitely help.
• Investing in an inflatable rubber ring: If being seated on cushions is causing immense discomfort, then one could opt for sitting on a rubber ring that could be inflated.

One could lower the likelihood of requiring an episiotomy by attempting to stand or squat that would assist one in laboring in an upright stance. A tepid compress application to the perineal part would also be helpful.

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