Episiotomy (from Greek "epision" meaning "pubic region", "tomy" meaning "cutting", aka perineotomy) is surgical incision of the perineum and posterior vaginal wall, during the second stage of labor, to quickly enlarge the opening for th ebaby to pass through.

Patient information

What is episiotomy? I know that -otomy means a cut, so do you cut the episi? What's that?
It's where you make a cut in to the perineum. The word "epision" is Greek for the pubic region, so that's why it's called that. But you can also call it a perineotomy .

What's the perineum?
The perineum is the area between the anus and the vulva. Or in men, the scrotum.

• Performed under local anesthetic, to the pudendal nerve (i.e. main nerve of the perineum)
• Incision can be done at:
  • 90 degree angle from the vulva towards the anus
  • At an angle from the posterior end of the vulva (medio-lateral episiotomy)
• Sutured closed after delivery

• Prevention, by birth canal widening (aka antenatal perineal massage), performed before the start of labour and achieving a 10cm opening to the birth canal so the baby's head can pass through easily. The procedure is safe and painless

• PPH (>500mL blood loss during childbirth, or >1L with a C section)

• One of the most common medical procedures performed on women, although its routine use in childbirth has steadily declined

• Perineal tear (unintended)
• Forceps
• C-section