Episiotomy, is a procedure where doctors cut the perineum (the area between the vagina and anus) to facilitate the baby’s emerging head. It is often referred to as “The Cut”.
If you need an episiotomy, you’ll receive an injection of a local anesthetic to numb the tissue if you haven’t had any other type of anesthesia. This is so you won’t feel your Doctor or midwife making the incision or repairing it after delivery.
How Common is it?
According to daula company Parent Link, 95 % of Singaporeans have episiotomies. Rates in other parts of the world ranged from a low of 9.7 percent in Sweden to close to 100 percent in Taiwan. China, Spain, South Africa, and Turkey also reported extremely high episiotomy rates, ranging from 63 percent to almost 90 percent.
According to Doctors here in Singapore, the reason episiotomy rates are so high is because distance between the vagina and the perineum is shorter in Asian women, thus there is a risk that the anus may tear.
Types of Episiotomy
There are three types of episiotomy; midline, medio-lateral and j-shaped episiotomy. For a midline cut, the skin of the perinuem is cut downwards towards the anus. In a medio-lateral one, the skin is cute downwards and diagonally. For a J shaped episiotomy the skin is cut downwards and either to the left or to the right.
Is there any negative side effects?
Current reseach indicates that is not as harmless as previously thought. For some women, an episiotomy causes pain during sex in the months after delivery. An episiotomy also increases the risk of fecal incontinence after delivery.
What can I do to prevent one?
For patients who have delivered before, an episiotomy may not be necessary if the baby is small and the perineum is wide or lax.
If this is your first childbirth, to soften the vaginal tissues for delivery, you may want to do a perineal massage. Perineal massage involves massaging the area between the vaginal opening and anus in the last weeks of pregnancy. Although there are no guarantees, stretching the tissues may reduce vaginal trauma during delivery.
How long till I heal?
The healing time depens on various factors, for example if the incision or tear is extensive, the tenderness may last longer. You should be completely recovered after six weeks of delivery. The stitches will dissolve automatically within two weeks after the wound has healed.
What can I do to aid healing
The area should be kept as clean as possible by washing with water and applying procaine spirit twice a day. Also change your maternity pads often.
Your Doctor would probably have prescribed you some oral painkillers. Remember to take them as this will help alleviate the pain.
Eat plenty of fibre and drink lots of fluids to keep your stool soft. Constipation leads to haemorrhoids (piles) which will further complicate your recovery. If you do have piles, use medications to help shrink it.
Use salt baths twice a day. Place 1 table spoon of salt in about four litres of warm water. Immerse your hips and buttocks in it for about four to five minutes twice a day.
Wear lose clothings so the wound can heal.
Begin doing pelvic floor excercises as this will improve blood flow to the area.
You can take the sting out of urination by squatting rather than sitting to use the toilet. Pouring warm water over your vulva as you’re urinating, might also alleviate some of the pain.