Episiotomies were once routinely performed in an attempt to prevent tearing during labor, particularly to avoid tears that reach to the anus. The number of episiotomies performed remains high in the U.S., but there is now a great deal of controversy over whether they should be routine. Recent studies have shown that women who do not have an episiotomy might have a small tear, which is in most cases not worse than an episiotomy.

To perform an episiotomy, local anesthesia (numbing just the immediate area) is usually used. Just before the baby is born, the obstetrician makes an incision at the bottom of the vaginal opening. This enlarges the vaginal opening. The incision is closed after the baby and placenta have been delivered.

• Reactions to medications
• Problems breathing

• Bleeding
• Infection

An episiotomy usually heals without complications. Normal activities can be resumed shortly after birth. The stitches (sutures) will be absorbed by the body and do not need to be removed.

Proper hygiene and avoidance of constipation is advised (if possible). Pain and discomfort can be relieved with warm baths and medications.