Why an Episiotomy

An episiotomy is a cut in your perineum that widens the opening of your vagina so your baby can be born more easily. Your midwife or doctor may perform an episiotomy if they think that you need an assisted birth, where your baby is born with the help of forceps or ventouse. If they think you are likely to have more than a small tear, or if your baby needs to be born quickly.

Many women who have a vaginal birth will have a tear of some kind or need to have an episiotomy.

How is a tear after birth diagnosed?

Tears are described in degrees, depending on how big they are, and which part of your perineum is affected:

Types of tears

First-degree

First-degree tears are small tears in your skin that usually heal without any treatment.

Second-degree

Second-degree tears are deeper tears that affect the muscle of your perineum, as well as your skin. You will probably need stitches for these to heal.

Third-degree

A third-degree tear goes downwards from the wall of your vagina and perineum to your anal sphincter. 

Fourth-degree

A fourth-degree tear affects the anal sphincters, plus the lining of your back passage or the lower part of your bowel (your rectum).