Does an obstetrician perform an episiotomy?

An episiotomy is a surgical cut in the perineum, the tissue between the vaginal opening and anus, to widen the opening during birth. An obstetrician or another trained birth clinician assesses the baby's position, the speed of birth, and the condition of the tissues before recommending it. If there is time, the team explains the reason and pain relief. After delivery, the cut is checked and repaired with stitches if needed, followed by advice about hygiene and recovery.

During pregnancy, discuss your preferences for perineal support and ask when an episiotomy might be considered. During labour, tell the team if pain relief is inadequate. After birth, follow advice about washing, sitting comfortably, pelvic-floor care, and prescribed pain relief. Mention difficulty walking, sitting, passing urine, or opening your bowels at your follow-up.

Seek prompt maternity advice after an episiotomy for increasing pain, spreading redness, wound opening, pus, fever, unpleasant-smelling discharge, or difficulty passing urine. Heavy bleeding, fainting, chest pain, or breathlessness needs urgent assessment. Contact the maternity team if pain is not improving or you are worried about healing.

Ask: Why might an episiotomy be needed? What pain relief is available? Where would the incision be made? How will it be repaired? Which wound changes should prompt a review?