--An episiotomy is an incision, either straight down (midline) from the vaginal introitus (opening) towards and into the perineum, or is a medio-lateral incision off to the right or left side.
Why would an episiotomy be indicated or needed?
-- If there is an urgent or emergent need to deliver the baby quickly, and time is of the essence, then an episiotomy might be necessary. If, however, the mother is pushing well, and the baby is tolerating labor fine (no distress), then an episiotomy is not needed. -- If the woman has undergone female genital mutilation , she may not physically be able to stretch her vaginal introitus to allow the passage of the baby during birth.
Should an episiotomy be required at all births?
-- Absolutely NOT! It should not be a routine intervention at any birth. It is a surgical procedure.
Will I feel the incision?
-- Most of the time, no. Sometimes the coverage from an epidural will numb the area enough. Other times, a local anesthetic is needed in addition to an epidural to help numb the skin and muscle. Or, if the woman does not have an epidural, local anesthetic would definitely be required before cutting an episiotomy.
How is an episiotomy repaired?
-- A type of suture that dissolves in about 3 weeks is used to help bring the muscles and skin back into correct anatomical position.
How long does it take to heal from an episiotomy?
--It can take several weeks (3-4 weeks, or more) to heal from an episiotomy. It takes approximately 3 weeks for the sutures to fully dissolve, and it will probably take several more weeks for the incision to completely finish the healing process. In general, it takes longer to heal from an episiotomy (a straight line/cut) than it takes to heal from a laceration (a jagged tear).
How long will I have pain and discomfort?
-- It can take 6 weeks or more for the pain to totally dissipate from an episiotomy. Always contact your care provider if you have severe or worsening pain.
What does an episiotomy scar look like when it is healed?
-- It should look like a scar as you would have anywhere else on your body. At first, the healed incision will look pink as it develops granulation tissue as part of the healing process. It might look like this for several months. Eventually, the scar will fade in color until it's a white/gray appearance. An old episiotomy scar can usually be seen as a faint white/gray line on the perineum when a woman is pushing out her next baby.