![]() What are the advantages of getting an episiotomy? You can expect some pain and soreness once the anesthesia wears off. In some cases, you've already had an epidural and can't feel anything from your waist down. Your obstetrician uses a local anesthetic (typically injected into the area) to numb your perineal area so you don't feel pain. You shouldn't feel anything during an episiotomy. The most severe type of tear with the most complications. Fourth-degree: The tear affects the vaginal lining, vaginal tissues, anal sphincter and rectum.Third-degree: A tear that involves your vaginal lining, vaginal tissues and extends to your anal sphincter.Second-degree: A tear that extends through the lining of your vagina to the underlying vaginal tissue.First-degree: A small tear that involves just the lining of your vagina.Like perineal tears, healthcare providers describe the levels (or degrees) of episiotomy in relation to how severe the tear is. Disadvantages of mediolateral incisions include difficulty to repair, greater blood loss and more discomfort during recovery. There's less chance of the incision extending to the anal sphincter and rectum. The incision begins at the vaginal opening and extends at a 45-degree angle. Mediolateral: An angled or diagonal incision.This type has a higher risk of tearing to the anal sphincter or rectum, but is an easier incision to make. Median (midline): A vertical (up and down) incision beginning at the vaginal opening extending toward the anus.They evaluate the degree of the tear and check for complications. Your provider uses absorbable stitches to repair the tissues and muscles affected.Your baby is delivered, followed by the placenta.Once your baby is crowning (your baby's head is at your vaginal opening) and pushing against the perineum, your provider uses episiotomy scissors to make the episiotomy incision.If you haven't had an epidural, your provider injects a local anesthetic into the perineum. You may not need any additional anesthesia. If you've already had an epidural, you don't have feeling from your waist down. You'll get anesthesia so you don't feel pain.Generally, an episiotomy follows this process: The specific process may vary depending on your obstetrician and your condition. But newer research has shown episiotomies may not prevent complications and may make tears extend farther than intended.Īn episiotomy is performed during a vaginal delivery. Your pelvic floor consists of muscles and tissue that support your uterus and help prevent urinary and bowel dysfunction. Some also believed it could prevent complications like urinary incontinence and pelvic floor dysfunction. Healthcare providers once thought making a surgical incision would help the vagina stretch and prevent severe tears. The latest research suggests it's better to let the perineum tear naturally. Is it better to tear or have an episiotomy? You've been pushing for too long or can't control pushing. ![]()
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