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Research shows that routine use of episiotomies (surgical cuts in the area between the vagina and anus) does not keep the mother's skin from tearing during birth. It does not speed up a normal birth. It does not help avoid the bladder control problems women sometimes get after having a baby.
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What You Need to Know
An episiotomy is a surgical cut in the perineum. (That is the area between the vagina and the anus.) When a woman has a baby, the doctor, nurse-midwife, or midwife may make this cut.
If you are pregnant, you should talk to your doctor, nurse-midwife, or midwife about episiotomies, just as you talk about whether you want pain medicine during childbirth. Do it before you get to the delivery room!
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To Have or Not to Have an Episiotomy?
Some doctors perform episiotomies for every birth. Researchers looked at the evidence for this routine use of episiotomies. They did not look at special cases, such as when a baby's shoulders get stuck during birth.
The research shows that routine use of episiotomies does not keep the mother's skin from tearing during birth. It does not speed up a normal birth. It does not help avoid the bladder control problems women sometimes get after having a baby.
You should know that:
- Both episiotomies and tears that occur when giving birth may be painful. They may be slow to heal. They can become infected.
- If you do not have an episiotomy, your skin may tear during delivery. But the tear is likely to be smaller than an episiotomy and to heal with less pain.
Women who do not have episiotomies:
- Are likely to start having sex sooner after childbirth than women who have them.
- Have less pain the first time they have sexual intercourse after childbirth.
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What Should I Do?
- Talk with your doctor, nurse-midwife, or midwife. Ask the reasons they might perform an episiotomy. Ask how often they perform them.
- Tell your doctor, nurse-midwife, or midwife any questions or concerns you have about having an episiotomy.
- Tell them what you prefer. Your voice counts!
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U.S. Department of Health and Human Services
Agency for Healthcare Research and Quality
AHRQ Publication No. 06-0005
Current as of December 2005