Should I Have an Episiotomy, or Risk Tearing During Labor and Delivery?

Wow, talk about two unpleasant choices!

We don't blame you for not wanting an episiotomy during labor and delivery. Who would want their doctor cutting through their perineum? Sounds terrible! And anyone who's ever had to recover from one can tell you that it feels pretty terrible, too.

For a long time, though, episiotomies were routine practice. Doctors thought that since so many women tear during labor and delivery anyway, they might as well make a surgical incision that would be neater, straighter, and more controlled. But studies soon showed that these routine episiotomies didn't help labor and delivery at all, and were associated with higher rates of infection, incontinence, pain during sex, bowel problems, and more uncomfortable recovery. Yikes.

So these days, doctors only perform episiotomies during labor and delivery if they really need to. Unfortunately, many women (about 70 percent) do tear while they are giving birth. If you want to minimize this risk, talk to your doctor about learning perineal massage, which can soften the tissue in the area during the weeks before labor and delivery. It's also important not to start pushing too soon, as tearing is more likely if you aren't fully dilated and the tissues haven't stretched out yet. But if you do experience ripping during labor and delivery, chances are good that the tear will be smaller than the standard episiotomy.

If you end up with an episiotomy after labor and delivery, don't sweat it, because the doctor obviously felt that it was the best, safest option for your baby. Just make sure to follow her instructions for care while the incision heals.