Back to What happens in labour and birth. Sometimes a doctor or midwife may need to make a cut in the area between the vagina and anus perineum during childbirth. This is called an episiotomy. An episiotomy makes the opening of the vagina a bit wider, allowing the baby to come through it more easily. Sometimes a woman's perineum may tear as their baby comes out. In some births, an episiotomy can help to prevent a severe tear or speed up delivery if the baby needs to be born quickly.
If your doctor or midwife feels you need an episiotomy when you're in labour, they will discuss this with you. In England, episiotomies are not done routinely. Up to 9 in 10 first-time mothers who have a vaginal birth will have some sort of tear, graze or episiotomy. If you have a tear or an episiotomy, you'll probably need stitches to repair it.
Dissolvable stitches are used, so you will not need to return to hospital to have them removed. An episiotomy may be recommended if your baby develops a condition known as foetal distress, where the baby's heart rate gets faster or slower before birth.
This means your baby may not be getting enough oxygen and has to be delivered quickly to avoid the risk of birth injuries or stillbirth. Another reason for an episiotomy is because it's necessary to widen your vagina so instruments, such as forceps or ventouse suction, can be used to help with the birth. Research shows that in some births, particularly with forceps deliveries, an episiotomy may prevent tears that affect the anal muscle third-degree tears.
An episiotomy is usually a simple procedure. A local anaesthetic is used to numb the area around the vagina so you do not feel any pain. If you have already had an epidural, the dose can be topped up before the cut is made. Whenever possible, the doctor or midwife will make a small diagonal cut from the back of the vagina, directed down and out to one side.
