Making The Cut – Are Episiotomies Justified?

EpisiotomyIf you are pregnant, or about to give birth within the next few weeks, you have probably heard the term -episiotomy’ and you are more than likely a little unsure about what it entails and why it is done? An episiotomy is performed when a woman gives birth naturally and it is an incision or cut that is made between the vagina and the rectum.

The thought process behind performing an episiotomy is to increase the size of the vagina opening, which allows for more space for the baby to pass through. In the 1980s and early 90s, episiotomies were performed routinely but today’s obstetricians are second guessing the decisions made by the predecessors and many women are questioning if episiotomies are really necessary.


The advantages of an episiotomy

There are still a large number of obstetricians who believe that this procedure is able to decrease the pushing during birth and that with an episiotomy the vaginal tissues and muscles are spared from additional trauma, as the space for delivery has been made wider. In the same vein, medical professionals who are advocates for an episiotomy believe that if the procedure was not done, the vaginal muscles would tear and need to be repaired anyway. The thought process behind this argument is that a neat and precision surgical cut is far better and far easier to repair than a jagged and unplanned tear, and as such, the episiotomy is able to save the woman and medical staff from suffering from complications.

Today’s obstetricians are now wondering if getting involved and performing surgical procedures, such as an episiotomy is warranted during natural childbirth and even though the procedure has a worthwhile advantages, the complications may very well downplay the advantages.


Possible complications of the episiotomy

All surgical procedures are performed with a degree of risk, and an episiotomy can lead to tears in the muscles of the rectum. Other possible complications of the surgery include bleeding, wound infection, pain and even the possibility of future sexual dysfunction. Taking into account that the wound is performed in an area that is always moist – the possibility of developing an infection is relatively high.

Another feasible argument that supports the question of if an episiotomy is really necessary is that when the procedure is performed, there is a high possibility that the blood vessels in the rectum can be damaged, which will lead to additional complications and the possibility of haemorrhaging.

A medical report dealing with the possible complications that may arise after the procedure has been performed, indicated that women were at risk of developing tumours on the episiotomy site and furthermore many women felt that the procedure was directly linked to their lowered sex drive, as pain was experienced during intercourse – this could be due to the fact that the incision was not repaired correctly.


An episiotomy as a last resort

There are certainly cases where an episiotomy has to be performed, such as when the baby is showing signs of distress (a baby’s head is large) and with the vaginal opening being made larger, the baby is able to birth quicker. However, the episiotomy should not be considered as a routine procedure that is to be performed with every natural birth.

If you have undergone an episiotomy, it is vitally important to follow good hygiene practices and there are many natural pain reliving techniques which will not only help to reduce the pain and inflation around the site, but at the same time, the natural techniques will aid with healing.


Facts to consider

The fact is that about 60% of all vaginal births will not require an episiotomy. Furthermore, the obstetrician is not able to predict the need for an episiotomy, but the decision can only be made once the woman is ready to birth her baby.


 – Kathy


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