Here's another great blog we wrote for Bellies Inc. If you want more information on preparing for labour, see your Pelvic Floor Physiotherapist!

There are few words scarier to pregnant women than this one that begins with an “e” and ends in an “ouch.” Let’s take a look at just what an episiotomy is, when it might be necessary, but what you can do in pregnancy to help avoid one.

An episiotomy is a surgical cut to the muscular area between the vagina and the anus - the perineum - and it is performed by an obstetrician or midwife during delivery. A cut widens the vaginal opening for baby’s head to come through. Episiotomies were once performed routinely during delivery, as it was thought that a clean cut was preferred (for healing) to a spontaneous tear. Thankfully, we now know a great deal more about the muscles of the vagina and pelvic health, and episiotomies are no longer recommended. The instances during delivery are on the decline.

Studies show that women who have episiotomies, as opposed to a natural tear, have a longer recovery time and greater pain postpartum. They are more likely to experience pelvic floor dysfunction, including anal incontinence (trouble holding in the bowels). What’s more, women who have episiotomies with first births are likely to have greater tearing with subsequent deliveries. There are complications with episiotomies, including infection.

Why are episiotomies performed?

To enable the successful passage of your baby through the vaginal opening, the muscles of the vagina need to stretch to accommodate head and body size. The muscles sometimes cannot stretch enough, due to size of the baby or performance of the muscle itself which can result in tearing. In certain instances - extra large children or birth complications including a delivery that necessitates foreceps - the doctor will opt to cut the perineum to ensure safe passage and to avoid severe tearing.

What can you do to decrease your chances of an episiotomy?

Fortunately, our knowledge of pelvic floor health shows us a better way; train the muscles of the vagina during pregnancy to respond naturally to the pressure of baby’s head, to open up and stretch to the required size. We didn’t invent this! An old practice in African countries has women gently insert gourds into the vagina, in growing size, during pregnancy. The idea behind this is to gently and slowly stretch the muscles and teach them to open up for larger and larger circumferences. There is a better way than going the gourd route; the Epi-No is a device women can use during pregnancy that was built with this same ancient principle in mind. Insert what is like a soft balloon into the vagina and pump it up a little at a time as your body adjusts to this new demand. Kim sells the Epi-No in her story and has written a great blog post on how this works.

There are also several techniques you can use during delivery to calm yourself and your little one towards a healthier and more peaceful birth. Our exercise program, designed to begin in pregnancy, teaches you the core breath, as well as trains your body to handle birthing positions, like side-lying and squats, which are known to ease the passage of baby through the canal and out the vagina. For a more comprehensive look at how to prepare the body for birthing success, purchase Kim’s online course.

If an episiotomy happened to you, don’t worry. We can work with you through the healing process.

This blog originally appeared on the Bellies Inc. blog.

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