Episiotoomia

Episiotomy is a surgical incision made in the perineum, the area between the vaginal opening and the anus, during childbirth. The purpose of this procedure is to enlarge the vaginal opening to facilitate the delivery of a baby or the insertion of surgical instruments. Historically, episiotomies were performed routinely on a large percentage of women during vaginal births. However, current medical guidelines and practices have shifted towards performing episiotomies only when there is a medical necessity.

The decision to perform an episiotomy is typically made by the healthcare provider during labor. Indications for the procedure can include fetal distress, the need for assisted delivery with instruments such as forceps or a vacuum extractor, or to prevent a severe tear of the perineum. There are two main types of episiotomy: median and mediolateral. A median episiotomy is a straight cut from the vaginal opening towards the anus, while a mediolateral episiotomy is an angled cut from the vaginal opening to one side.

Following the birth, the episiotomy incision is repaired with stitches. The recovery period can involve pain, discomfort, and swelling in the perineal area. Potential complications, though uncommon, can include infection, increased pain, and difficulties with sexual intercourse. The trend in modern obstetrics is to minimize episiotomies, reserving them for specific situations where they are deemed beneficial for the mother or baby. This approach aims to reduce the incidence of severe perineal tears and associated complications.