Which specialist performs episiotomy?

An episiotomy is a surgical cut made in the perineum, the tissue between the vaginal opening and anus, to enlarge the vaginal opening. The obstetrician assesses the birth as it progresses and explains the reason when there is time to do so. A midwife may support your care and communicate with the obstetric team, but the scope identifies obstetrics as the performing specialty.

The cut is repaired after birth, usually with stitches that dissolve as the area heals. Whether an episiotomy is appropriate depends on the circumstances of labour, the baby's position and wellbeing, and the condition of the tissues.

Include episiotomy in your birth-plan conversation. Ask your maternity team when they might recommend it, what alternatives could be considered, how numbing medicine is used, and how the wound is cared for afterward. You can share preferences, while the obstetrician must respond to changing clinical needs during birth.

After delivery, keep the area clean and follow the instructions for pain relief, washing, and checking the stitches. Mention increasing discomfort or difficulty passing urine rather than waiting for a routine visit.

Contact your maternity service promptly if the wound becomes increasingly painful, swollen, hot, or difficult to sit with, or if you notice pus, a strong unpleasant smell, fever, or the edges opening. Seek urgent help for heavy bleeding, faintness, severe pain, or trouble controlling urine or stool.

Ask: Who would perform an episiotomy in my birth setting? What circumstances would make you recommend one? How would you numb and repair the area? Which symptoms after birth should prompt a same-day call?