Is Episiotomy necessary?
When a future mother goes to the beginning of her prenatal control, she always asks about the episiotomy. In Panama it is known as “stinging” or “cutting”. It is a real torment. To feel that it’s obligatory in order to have a natural birth, the doctor has to cut the vulva and the perineum!
The answer is NO!
Medicine based on evidence, which means that after multiple studies with large groups of populations, recommends clearly not performing a routine episiotomy in any birth.
Every woman knows what they have to do for her not to get hurt. The only thing we do is discuss during pregnancy how does she have to let the head and the body of the baby out, slowly so that she doesn’t have any lacerations. Surprisingly they all make it. And it’s not even hard.
The last time I did an episiotomy was 12 years ago and personally I attend births every day.
If a tearing or laceration is produced, it is always going to be less than a cut with a scissor that is very anti natural and painful. Little lacerations in the vaginal membrane may be produced, that most of the times doesn’t require any stitching, because the vaginal tissue it’s extremely noble and heals wonderfully. The pain after birth it is enormously greater if an episiotomy was performed in comparison with the lacerations that may occur. Also the risk of an infection it is significantly smaller and the sexual life doesn’t suffer any changes of any kind to the women who hadn’t had and episiotomy performed.
So the answer is NO. It isn’t necessary to perform a routine episiotomy and it’s scarcely the situations when it’s necessary to do it, independently of the existence of previous births or not.
Dr. Rodrigo Aybar