- Research provides no evidence that an episiotomy reduces the risk of perineal injury, improves perineal healing, prevents birth injury to babies or reduces the risk of future incontinence. Rather, the evidence shows that routine or liberal use of episiotomy is likely to be ineffective or harmful.
- The World Health Organization (WHO) recommends eliminating routine or liberal episiotomy.
You May Need an Episiotomy If:
- You or your baby is in distress.
- Your baby is very large or in an unusual position.
How to Avoid an Unnecessary Episiotomy
- Ask potential caregivers their thoughts about episiotomy and choose your caregiver carefully.
- Push in upright positions that allow your perineum to stretch gently as your baby descends.
- Change positions often while you’re pushing.
- Push spontaneously, according to your body’s signals, not in a directed way.
- Remember that your body knows how to give birth.
- Be patient with your body.
What You Can Do If You Have an Episiotomy
- After birth, take warm baths to increase circulation and decrease pain and apply ice to reduce swelling.
- After birth, start doing Kegel exercises as soon as possible to help heal and strengthen your perineal muscles.
Your perineal muscles support your uterus and other organs like a hammock. Kegel exercises strengthen these muscles and are important for all women to do. If you have an episiotomy, Kegels increase circulation, decrease swelling and help healing. Here’s how to do a Kegel:
- Get in any position: Sitting, standing, or lying down.
- Focus on the muscles around your urethra and vagina, not the muscles of your buttocks, thighs or abdomen.
- Tighten (contract) your perineal muscles as if you were trying to stop urinating. It should feel like you’re lifting them.
- Hold this contraction as tightly as you can for a slow count of ten. Don’t hold your breath. As you master this exercise, increase your count to 20.
- Repeat ten times throughout the day.