In some cases, during the process of childbirththere is a need for a perineal incision. This minor surgical procedure is necessary when the elasticity of the cervix is low to avoid ruptures, when the fetus is at risk to speed up delivery, etc. There are different opinions about the need for this operation and it is better to discuss all the pros and cons with your doctor in advance.
The benefits of episiotomy include:
- expansion of the birth canal;
- a rectilinear incision is easier to sew than larger gaps;
- acceleration of delivery for 15-30 minutes, which is especially important for prolonged childbirth, when the labor of the parturient is exhausted;
- made in time, the incision prevents damage to the perineal and vaginal muscles;
- If additional forceps or vacuum extractors are required, additional space is created;
- when a premature baby is born, the pressure on the baby's head is reduced.
Opponents of episiotomy believe that birth should take place naturally, and note some negative points:
- discomfort in the early postpartum period;
- execution of the procedure without special need;
- the risk of infection in the place of incision;
- possible pain during intercourse for several months after childbirth.
There are mainly two types of episiotomy performed:central (along the middle muscle) and mediolateral (central-lateral). The central incision is made directly to the back, in the direction of the anus. Despite its advantages (relative to the length, the incision causes a greater expansion of the outlet of the birth canal, heals well, is easier to suture, causes less bleeding, less often causes postpartum discomfort and does not have an infection), it is less often used due to the high risk of rupture of the perineum to the anus. In order to avoid this danger, most doctors, especially in the first birth, choose a mid-lateral incision that bypasses the anus. Paradoxically, in practice, a protective incision heals much better than a protective rupture. And one more "pro". If the muscles are not torn, they are subject to such a strong stretch that their tone decreases in the future and can lead to prolapse of the uterus. You can discuss all the pros and cons with your doctor, but you should remember that the final decision will be made in the delivery room, taking into account your condition and, first of all, taking into account the possibility of a safe birth of the child. We recommend reading: