Clinical Commentary
An episiotomy is an incision made in the perineum (the tissue between the vaginal opening and the anus) and vagina to enlarge the vaginal opening (RCOG 2015). Episiotomy can shorten the second stage of labour, but the consequences of the trauma to the perineum and, potentially to the anus and rectum, need to be balanced against the need for episiotomy. The use of episiotomy must be discussed prospectively with the woman (RCOG 2015).
Evidence suggests that selective use of episiotomy is better practice than routine use of episiotomy and may reduce the level of pain, urinary incontinence, painful sex or severe perineal trauma (Jiang et al. 2017; RCOG 2015).
References
Jiang H, Qian X, Carroli G & Garner P 2017. Selected versus routine use of episiotomy for vaginal birth. Cochrane Database of Systematic Reviews 2: CD000081.
RCOG (The Royal College of Obstetricians and Gynaecologists) 2015. The management of Third- and Fourth-degree Perineal Tears: Green top guideline no. 29 (PDF). Viewed 6 October 2021.