An episiotomy is a cut that is made in the perineal tissue during a vaginal delivery.
An episiotomy is a cut that is made, during a vaginal delivery, in the perineal tissue.
That is, the superficial skin/muscle and fatty tissue between the lower edge of the vagina and the anus.
Such a cut is made at an angle of 60°, precisely to prevent the woman from tearing from the lower edge of the vagina to the anus.
So a cut does damage the pelvic floor zone, but it is intended to make more room. In this way, you can avoid tearing deeper into important pelvic floor muscles (especially the sphincter muscles around the arse).
Scientifically robust guidelines show that an episiotomy
is a good and smart decision
in some women,
in some situations...
This will be the case in about 1 in 5 births, for instance if there is a risk of severe tearing or if it would be necessary to use a suction cup or forceps. Usually, the gynaecologist will anaesthetise the area locally and then make the cut. After delivery, everything is checked thoroughly. The gynaecologist checks the incision and any additional tears and sews the different layers of the pelvic floor back together nicely.
Recent scientific research shows
that giving pregnant women good and understandable information about
what the cut is exactly,
why it sometimes has to be made
and how it will heal,
has a very positive influence on the woman's experience .
Important scientifically substantiated findings that we would like to emphasise.
Pregnant women are all too aware that giving birth vaginally will be a challenge and may be difficult.
It is normal to feel a little anxious or stressed about this beforehand. That is why it is so important that you know what the possible options are.
"An episiotomy", "a cut" can sound quite scary when you think about cutting into your most intimate area.
But if you know in advance why it might be necessary (in some cases);
and that your doctor will only ask or do this to avoid other problems,
then you will be much more reassured.
Good information beforehand will therefore help you to control your fears a little better.
And hopefully help you to decide and accept what is the best decision for you at that very exciting moment.
After delivery, the scar (the suture) from a cut can sometimes feel awkward and cause pain for about two weeks. But this is also the case for women who did not have a cut or who did not tear. The pelvic floor is often swollen from the stretching of a vaginal birth and gives a kind of blue- spot feeling. It is normal for this area to take some time to heal. In the next blog, we will certainly give you more tips on how to best deal with this pain.
So be sure to discuss your questions in advance with your gynaecologist, midwife or physiotherapist.
Conclusion
More good and quality information, will help you to:
- to better assess the possible options in advance,
- reduce your fear of giving birth,
- will help you feel calmer and more relaxed during childbirth,
... which can make childbirth easier!
and
... will help you to accept any complaints you may feel afterwards or at least to give them a temporary place...
Endless benefits!
An informed woman is worth two! And in this case, at least three!
Prof. Dr. Yves Jacquemyn, Department Head of Gynaecology and Obstetrics UZA
Hedwig Neels, Physiotherapist, Gynaecology and Urology UZA
Reference article:
Patient attitude and acceptance towards episiotomy during pregnancy before and after informationprovision: a questionnaire. AlexanderJ et al, IUJ, 2020.
DOI: 10.1007/s00192-019-04003-x
