Can You Avoid an Episiotomy During Childbirth?

February 9, 2019
In recent times, developments have been made to help prevent episiotomy during childbirth, which is a cause of great concern for pregnant women.

If you’re expecting, you may be afraid of tearing or cutting the perineum during birth. However, many experts suggest limiting the use of this practice except when absolutely necessary. Next, we’ll give you some tips to avoid having an episiotomy during childbirth.

What is an episiotomy?

It consists of making a small incision in the perineum, the area between the vagina and the rectum where the baby’s head begins to emerge. The incision extends the opening by 3-4 centimeters (1-1.5 inches) to facilitate the expulsion of the baby.

This practice started in order to avoid muscle tears in the perineal area at the time of delivery and has become routine in such a way that, for example, more than 80% of women in Spain have had this procedure done.

Can You Avoid an Episiotomy During Childbirth?

How to avoid an episiotomy during childbirth?

You can protect the perineal area by placing a warm compresses over it to give time for the expulsive period to take place. Perineal massages with oils and Kegel exercises are recommended during the last six weeks.

Some specialists like Asunción Gómez, physical therapist and midwife, believe that as long as the perineum is healthy and integrated into the body’s schema, the risk is lower. In addition, you must allow it to slowly and naturally distend.

To avoid an episiotomy during childbirth, you can choose the services of a midwife. This helps you give birth in the most natural way possible, making perineal cuts only when absolutely necessary.

This favors natural childbirth and the least amount of surgical interventions. Another option you should consider is a water birth, which usually reduces pain and perineal cuts.

Kegel exercises

With Kegel exercises, you contract and relax the muscles of the pelvic floor. One way to do this is to sit on the toilet with your legs spread and stop urination at 5-second intervals. Then let it flow again without moving your legs and breathe gently.

Repeat this series of exercises 10 times, several times throughout the day. If possible, increase the relaxation and contraction time until it reaches 20 seconds.

The objective is to strengthen the muscles of the perineum to make it more resistant and elastic. Therefore, a pregnant woman can relax that area and create flexibility to achieve a good dilation during the expulsion of the baby.

This way, the baby’s head can easily emerge and thus she can avoid having an episiotomy during childbirth.

Prenatal massage in the perineal area

You can do these massages in the third trimester of pregnancy. How? Well, the right time is after taking a shower.

Saturate the entire perineal area with rosehip or almond oil. With your thumbs, massage the area in a U shape, pressing a little downward and outside. Repeat the movement until you feel a slight stinging sensation.

Doing these movements consistently will soften and stretch the tissues, so that increases the elasticity of the perineum. They also prepare a pregnant woman for the sensations of tension and pressure that she’ll experience during childbirth.

Can You Avoid an Episiotomy During Childbirth?

When should an episiotomy be done?

An episiotomy should be performed when there is a risk of fetal distress – in complicated or dystocia births, and in women who have suffered a vaginal tear in a previous birth.

If the perineum is cut correctly and sutured with precision, recovery is simple, the discomfort lasts a few days, and the stitches fall off on their own.

To alleviate the discomfort, you can place cloths of warm water in the area and maintain good hygiene habits. When washing the wound, dry it and cover it with a compress as often as possible. You should also avoid astringent foods.

  • Carroli, G., & Belizán, J. (2008). Episiotomía en el parto vaginal. La Biblioteca Cochrane Plus, (2)
  • Liljestrand J. Episiotomía en el parto vaginal. Comentario de La Biblioteca de Salud Reproductiva de la OMS (última revisión: 20 de octubre de 2003); Ginebra: Organización Mundial de la Salud
  • Signorello LB, Harlow BL, Chekos AK, Repke JT (2000). «Midline episiotomy and anal incontinence: retrospective cohort study»