episiotomy

Episiotomy, also known as perineotomy, is a surgical incision of the perineum and the posterior vaginal wall generally done by an obstetrician. This is usually performed during the second stage of labor to quickly enlarge the aperture, allowing the baby to pass through. The incision, which can be done from the posterior midline of the vulva straight toward the anus or at an angle to the right or left (medio-lateral episiotomy), is performed under local anesthetic (pudendal anesthesia), and is sutured after delivery.

Its routine use is no longer recommended, as perineal massage applied to the vaginal opening is an alternative to enlarge the orifice for the baby. It was once one of the most common surgical procedures specific to women. In the United States, as of 2012, it was performed in 12% of vaginal births. It is also widely practiced in many other parts of the world, including Korea, Japan, Taiwan, China, and Spain in the early 2000s.