EPISIOTOMY
This is a surgical incision made in the perineum to enlarge the vaginal opening
and assist in childbirth. It is one of the most common female surgical procedures.
American-trained physicians tend to prefer a midline episiotomy whereas
British-trained physicians tend to perform mediolateral episiotomies. It is not
practiced routinely in the United States today because the arguments made in its
favor have not been shown to have scientific support.
False arguments: less perineal pain; more rapid return of sexual activity; less
urinary incontinence; less pelvic prolapse
Disadvantages: more perineal pain than with lacerations; longer return to
sexual activity; more extensions into the anal sphincter and rectum
Possible indications: shoulder dystocia, non-reassuring fetal monitor tracing,
forceps or vacuum extractor vaginal delivery, vaginal breech delivery, narrow
birth canal