Episiotomy and Second or Third Degree Tears

What is an episiotomy?

It is sometimes necessary for women to have a surgical incision to make the delivery of the baby easier. A cut is made in the woman’s perineum which is the area between the vagina and anus. The cut makes the opening of the vagina a bit wider which allows the baby to be delivered more easily.

Why is an episiotomy performed?

If the baby becomes distressed during the labour then the heart rate may significantly increase or decrease, this can mean that the baby may not be getting enough oxygen. When this occurs it is essential to deliver the baby quickly to avoid the risk of any damage or stillbirth. In some situations like this a caesarean section may not be appropriate if the labour is too far progressed and the baby’s head may already have moved down the birth canal.

Therefore, when such issues occur and episiotomy is performed as this will enable the baby to be delivered more easily especially when  there is a need to use forceps or ventouse delivery methods.

Some other scenarios where it may be necessary to perform an episiotomy are:

  • the mother has a pre-existing health condition and it is essential to have a speedy delivery to reduce any complications
  • the baby is in the breech position
  • the labour has been slow to progress and the mother is becoming exhausted
  • if it is considered the mother will tear more severely without such an incision being made

This is not an exhaustive list and merely gives an insight into some scenarios when this procedure may be required.

How is an episiotomy performed?

Local anaesthetic is normally used to numb the area. However, if an epidural has already been used then the dosage may be increased before the incision is made. The doctor or midwife will then make the incision.

What happens after an episiotomy has been performed?

After a woman has given birth and an episiotomy was performed during labour, then it is necessary for the area where the incision was made to be stitched, this is normally done within an hour of the baby being born. The cut may bleed quite a lot initially, but this should stop with pressure and stitches.

Normally dissolving stitches are used and normally the stitches heal after a month or so. It is normal that the area where the incision was made will be painful for a number of weeks after the baby is born. In addition many women find that sex can be painful for a number of months after an episiotomy.

It is essential that you check for any signs that the cut or the area around it has not become infected. An infection can be indicated when the area is red, swollen skin, discharge of pus or liquid from the cut or persistent pain.

When Does An Episiotomy Amount to Clinical Negligence?

There are some complications which can occur following an episiotomy  including:

  • Anal incontinence;
  • Extreme pain;
  • Increased chance of having a third degree tear;
  • Problems with sexual intercourse.

When complications do arise, they are not always negligent. However, in some circumstances the problems the mother is experiencing may be due to the negligence of the medical professional such as:

  • the episiotomy has not been performed to an appropriate standard/using poor technique;
  • the equipment used was of a poor quality and has caused further damage to the mother;
  • when the incision was made it caused unnecessary damage to other areas;
  • the repair the incision was performed to a poor standard;
  • there was a delay in diagnosing and treating an infection of the wound

If you are concerned about the treatment you received when an episiotomy was performed please contact us today for a free no obligation chat.