For many years, episiotomy was routinely performed during childbirth in hospitals around the world. It was believed that making a surgical cut in the perineum , the area between the vagina and anus would help babies be born more quickly and prevent severe tearing.
However, modern research and updated maternity guidelines now show that routine episiotomy is not necessary for most births and should only be used in specific medical situations.
Understanding this practice helps mothers feel more informed and confident when discussing their birth options with care providers.
What Is an Episiotomy?
An episiotomy is a surgical cut made in the perineum during the pushing stage of labour to enlarge the vaginal opening.
It is usually performed when the baby’s head is about to be born.
Historically, doctors believed episiotomies could:
● Speed up delivery
● Prevent severe tearing
● Protect the baby during birth
But evidence now suggests that routine use may actually increase complications.
Why Routine Episiotomy Is No Longer Recommended
Research has shown that routine episiotomy may lead to:
● More severe perineal trauma
● Increased bleeding
● Greater postpartum pain
● Longer healing time
● Increased risk of infection
Because of these findings, organisations such as the World Health Organization (WHO) now recommend that episiotomy should not be performed routinely.
Instead, it should only be used when medically necessary.
When Might an Episiotomy Be Needed?
In certain situations, an episiotomy may still be helpful, such as:
● When the baby needs to be born quickly due to distress
● During some assisted births using forceps or vacuum
● If the baby’s shoulder becomes stuck (shoulder dystocia)
Even in these cases, the decision should be carefully explained to the mother whenever possible.
What Helps Reduce the Need for Episiotomy
Many practices can help protect the perineum and reduce the likelihood of needing an episiotomy:
● Upright or side-lying birth positions
● Slow, controlled pushing
● Warm compresses applied to the perineum
● Gentle guidance from the birth attendant
● Avoiding unnecessary rushing during the pushing stage
Allowing the body time to stretch naturally often leads to less severe tearing than a surgical cut.
Your Right to Informed Consent
Like any medical procedure, episiotomy should only be performed with informed consent whenever possible.
Mothers have the right to ask:
● Why is this procedure recommended?
● Is it urgently needed?
● Are there alternatives?
● Can we wait and allow the body to stretch naturally?
Being informed does not mean refusing medical care, it means understanding and participating in decisions about your body.
Conclusion
Birth is a natural physiological process designed to unfold gradually. While episiotomy may sometimes be necessary, routine use is no longer recommended in modern evidence-based maternity care.
With education, supportive care, and respect for the natural process of birth, many women can give birth safely without surgical cuts.
Understanding your options helps ensure that birth decisions are made with knowledge, respect, and confidence.
Learn How to Navigate Birth Decisions with Confidence
Understanding common birth practices such as episiotomy is an important part of preparing for labour. When mothers know their options, they feel more confident asking questions and making informed choices during birth.
🌸 Nurturing The Mothers — The Blessed Start Childbirth Education Course
In this course, you will learn:
● ✨ How labour progresses naturally
● ✨ Understanding common medical interventions and when they may be needed
● ✨ How to make informed decisions during labour
● ✨ Natural coping techniques for birth
● ✨ Preparing emotionally and spiritually for motherhood and much more..
