• Episiotomy

    (Perineum Incision; Incision, Perineum)


    The perineum is the area between the vagina and the anus. It is made up of skin and muscle. During an episiotomy, an incision is made in the perineum.

    Reasons for Procedure

    The incision is made to make the vaginal opening larger during birth. In the past, this incision was common. But it is no longer routinely done.
    Your doctor may do an episiotomy if:
      The baby is:
      • Premature or otherwise fragile
      • Large and the shoulders may be hard to deliver
    • Forceps or a vacuum are needed to assist in the delivery

    Possible Complications

    Some short-term complications may include:
    • Bleeding
    • Infection
    • Bruising
    • Swelling
    • Difficulty controlling your bowels
    Factors that may increase the risk of complications include:
    • Severe scar tissue in the area
    • Prior problems with chronic pain in the vulva
    • Short perineum

    What to Expect

    Prior to Procedure

    During a prenatal visit, talk to your doctor about the benefits and risks of an episiotomy.


    If you have not had epidural anesthesia during labor, the doctor may use local or regional anesthesia .

    Description of the Procedure

    The infant's head will start to stretch the vaginal opening. Special scissors will be used to make an incision in the perineum area.
    There are 2 different incisions that may be used:
    • Midline incision: starts at the vagina and follows a straight line to the anus
    • Mediolateral: starts at the vagina and continues at an angle
    Midline vs. Mediolateral Episiotomy
    Nucleus factsheet image
    Copyright © Nucleus Medical Media, Inc.
    After delivery of the baby and placenta, your doctor will close the incision with absorbable stitches.

    How Long Will It Take?

    This is done during childbirth.

    Will It Hurt?

    If you receive anesthesia, you will not feel pain during the procedure. After delivery, most women have discomfort and swelling. You may need to take pain medication.

    Average Hospital Stay

    The usual length of stay for vaginal delivery is 2 days. An episiotomy will not extend your stay.

    Postoperative Care

    Your stitches will dissolve in about 10 days. The cut will heal within about 2 weeks. There may still be some soreness until the skin gets its natural strength back. This could take up to 6 weeks. During that time, you may find it uncomfortable to sit or walk.
    While you recover:
    • When your doctor tells you to, do Kegel exercises . Simply squeeze the muscles you use to stop the flow of urine. This strengthens the pelvic floor muscles and can help the area heal faster.
    • Avoid having sex, douching, and using tampons for 6 weeks or as directed by your doctor.

    Call Your Doctor

    After arriving home, contact your doctor if any of the following occur:
    • Signs of infection, including fever and chills, swelling, redness, foul-smelling discharge
    • Pain that you cannot control with the medications you have been given
    • Bleeding from the episiotomy site
    • Continuing problems with loss of urinary or bowel control
    If you think you have an emergency, call for emergency medical services right away.


    American College of Nurse-Midwives http://www.midwife.org

    American Congress of Obstetricians and Gynecologists http://www.acog.org


    The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org

    Women's Health Matters http://www.womenshealthmatters.ca


    Episiotomies. Brigham and Women's Hospital website. Available at: http://www.brighamandwomens.org/departments%5Fand%5Fservices/obgyn/services/midwifery/patient/episiotomies.aspx. Accessed September 12, 2017.

    Episiotomy. ACOG practice bulletin No. 71. Obstet Gynecol. 2006;107:957-962.

    Episiotomy. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/labornbirth/episiotomy.html. Updated August 2015. Accessed September 12, 2017.

    Revision Information

  • LiveWell personal health survey

    How healthy are you really? Find out – free.Learn more

    It's time to stop guessing. If you want to make some changes but just aren't sure how, the free personal health survey from LiveWell is a great place to start.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease and prevent heart attacks. HeartSHAPE® is a painless, non-invasive test that checks pictures of your heart for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.

  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.