What does episiotomy mean in pregnancy?

An episiotomy is a surgical cut in the perineum to widen the vaginal opening during birth. Your team may mention it when discussing assisted vaginal birth, an urgent need to deliver, or concerns about a severe tear. Planning ahead can help you understand the circumstances, but a pregnancy appointment cannot predict whether you will need one. The cut is made only after considering the situation and explaining it when time allows.

Add your preferences to your birth discussion: ask when an episiotomy might be recommended, what pain relief is used, and how the wound is repaired. Tell the team about previous perineal injury, pelvic floor symptoms, or difficult recovery. After birth, follow advice about hygiene, movement, bowel care, and pain relief, and mention symptoms that are not improving at a postnatal review.

After an episiotomy, contact your maternity team for worsening rather than easing pain, increasing redness or swelling, fever, foul discharge, heavy bleeding, or a wound that appears open. Urgent assessment is needed for severe pain, faintness, or loss of bowel control. These symptoms can signal infection, bleeding, or injury that needs prompt care.

Ask how your previous birth history affects planning, which alternatives may be considered, how consent works in an emergency, and whom to contact if recovery is difficult.