Are you a loving mother-to-be? If so, you may have heard the term "getting a cut" when discussing childbirth. It is natural for many mothers to feel a bit of fear or anxiety when hearing these words. What exactly is this cut? In medicine, we call this an episiotomy. Is this done for everyone? Why is it done? In this article, we will answer all the questions you have about this.
What is an Episiotomy?
Simply put, an episiotomy is a small surgical incision made by a doctor in the skin and muscle tissue between the vagina and the anus (known as the perineum) during childbirth to widen the opening and help the baby pass through more easily.
Sometimes, as the baby is being born, this area may tear naturally without any incision. This is called a natural perineal tear. While episiotomies were once considered routine during childbirth, the current medical consensus is that it is better to allow for natural tearing unless it is absolutely necessary.
Why is an episiotomy still necessary?
Although it is not a routine procedure anymore, in certain special circumstances, the doctor may need to perform this incision for the safety of the mother and baby. Think of it like braking suddenly to avoid an accident on the road. Such essential situations include:
- If the baby is in distress (fetal distress) and needs to be delivered as quickly as possible.
- If the mother is exhausted after prolonged labor and no longer has the strength to push.
- If forceps or vacuum extraction tools are needed to deliver the baby. These tools require a slightly wider vaginal opening.
- If the baby's position is abnormal, for example, in a breech position or if the baby's shoulders are stuck (shoulder dystocia).
- If the baby is larger than average.
- If the baby is not coming out despite the mother pushing for a long time.
The most important thing is that a doctor only makes this decision if there are no other alternatives and it is deemed absolutely necessary for the safety of the mother and baby.
How is this cut made and what are the types of incisions?
You will not feel pain during an episiotomy. If you have already received an epidural, you will not feel anything below the waist, so no additional medication is needed. Otherwise, the doctor will inject a local anesthetic to numb the area. Then, as the baby's head begins to emerge (crowning), the incision is made with special episiotomy scissors. After the baby is born, the area is repaired with dissolvable stitches.
There are two main types of incisions.
| Type of Incision | Description |
|---|---|
| Median (midline) incision | This is a vertical incision made straight from the vagina towards the anus. It is easier to perform and less painful during healing. However, there is a slightly higher risk of tearing towards the anal sphincter. |
| Mediolateral incision | This is an incision made at a 45-degree angle from the vagina to the side. The risk of damage to the anal sphincter is lower. However, it is slightly more difficult to stitch, there is more bleeding, and there may be more pain during the healing process. |
Degrees of Tear
Whether it is a natural tear or an episiotomy, they are classified into 4 degrees based on severity.
- First-degree: Only the skin of the vagina is slightly torn.
- Second-degree: The tear extends through the vaginal skin and into the underlying tissues. Most episiotomies fall into this category.
- Third-degree: The tear extends through the vaginal tissue and into the muscles surrounding the anus (anal sphincter).
- Fourth-degree: The most severe level, extending all the way to the rectum, with the highest risk of complications.
What can you do at home to heal the incision quickly?
The first few weeks after the incision can be painful. However, with proper care, it can heal quickly. It usually takes about a month to heal completely. These tips will be very helpful to you.
| Method | Description |
|---|---|
| Ice Pack | Apply ice cubes wrapped in a clean cloth to the stitched area for 10-15 minutes. This significantly reduces swelling and pain. |
| Sitz Bath | Use a sitz bath basin that fits over the toilet or a large basin filled with warm water and sit in it for about 15 minutes. Doing this two or three times a day keeps the wound clean, improves blood circulation, and promotes faster healing. |
| Peri Bottle | Fill the peri bottle provided by the hospital with warm water and rinse the area after urinating or using the toilet. This reduces stinging and helps keep the wound clean. |
| Painkillers | Take the painkillers (e.g., Paracetamol) prescribed by your doctor at the recommended times. If you experience unbearable pain, inform your doctor. |
| Donut Pillow | Use a donut-shaped pillow when sitting to reduce pain. This relieves pressure on the stitched area. |
When should you see a doctor immediately?
Pay close attention to your body during the healing period. If you experience any of the following symptoms, do not delay in contacting your doctor or visiting the hospital's emergency unit.
- If the pain increases instead of decreasing day by day.
- If there is foul-smelling discharge or pus coming from the stitches.
- If the area around the wound is red, swollen, and feels hot to the touch.
- If there is bleeding from the stitched area.
- If you have a fever, chills, or body aches.
These could be signs of an infection, so seeking prompt medical attention is very important.
Take-Home Message
- An episiotomy is not performed in every childbirth anymore. It is only done if it is absolutely necessary for the safety of the mother and baby.
- Nirogi Lanka
episiotomy, childbirth, incision, perineal tear, childbirth, placenta, sitz bath, stitches, pregnancy, women's health
