What you need to know about episiotomy during childbirth!

Are you a mother-to-be? Then you've probably heard the term 'cutting' when talking about childbirth. It's normal for many mothers to feel a little scared and nervous when they hear these words. What exactly is this cutting? In medicine, we call it an episiotomy. Is this something everyone does? Why is it done? Today, we will answer all your questions about this in this article.

What is an episiotomy?

Simply put, an episiotomy is a small surgical cut that your doctor makes in the area of ​​skin and muscle between your vagina and anus (called the perineum) to make the passageway for your baby to come out more easily during childbirth.

Sometimes, when the baby comes out, this area can tear a little on its own without any incision. This is called a perineal tear. In the past, it was considered normal to have an episiotomy during childbirth, but today, doctors believe that it is better to let the tear go naturally unless absolutely necessary .

So, why is it still necessary to have an episiotomy?

Although this is not something that is commonly done now, in some special cases, the doctor has to make this incision for the safety of the mother and baby. Think of it, it's like stopping a car suddenly to avoid an accident while driving on the road. These are the most essential cases:

• If the baby is experiencing some discomfort (fetal distress) and you need to get the baby out as soon as possible.
• When the mother is very tired after going through labor pains for a long time and has no strength to push any further.
• If you have to use forceps or vacuum devices to remove the baby, the vagina needs to be a little bigger to allow these devices to be inserted.
• If the baby is in an abnormal position, for example, if they are breech or if the baby's shoulders are stuck (shoulder dystocia).
• If the baby's size is larger than average.
• When the mother pushes for a long time but the baby doesn't come out.

How is this incision made and what are the types of incisions?

You won't feel any pain when you have an epidural. If you already have an epidural, you won't need any pain medication below the waist. Otherwise, the doctor will inject a local anesthetic just where the incision will be made. Then, as the baby's head begins to emerge from the vagina (crowning), the incision is made with special scissors (episiotomy scissors). After the baby is born, the area is repaired with dissolvable stitches.

There are two main types of cuts.

Degrees of Tear

Whether it's a natural tear or an episiotomy, it's divided into 4 degrees depending on its severity.

• First-degree: A slight tear of only the skin over the vagina.
• Second-degree: A tear that extends through the skin of the vagina and the underlying tissue. Most episiotomy cuts fall into this category.
• Third-degree: Tearing of the vaginal tissue and the muscle around the anus (anal sphincter).
• Fourth-degree: The most severe and most complicated level, with a tear extending all the way to the rectum.

What can you do at home to help a cut heal quickly?

The first few weeks after the incision can be painful. But with proper care, you can heal quickly. It usually takes about a month to fully heal. These things will help you a lot.

When should you see a doctor immediately?

Pay close attention to your body during your recovery. If you have any of the following symptoms, call your doctor or go to the hospital's Emergency Department (ETU) without delay .

• If the pain is getting worse instead of decreasing day by day.
• If there is a foul-smelling discharge or pus coming from the suture site.
• If the area around the wound is red, swollen, and feels hot to the touch .
• If there is bleeding from the stitches.
• If you have a fever, chills, or body aches .

These can be signs of an infection, so it's important to seek treatment quickly.

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