Vaginal Births vs. Cesarean Sections & Episiotomy: Understanding Your Options

Question
Hello Dr. Rappaport,
      I just wanted to know the difference and similarities between a vaginal birth and a episiotomy.


Answer
An episiotomy is an incision that is made in the perineum (between the opening of the vaign and the rectum) in order to facilitate the delivery of the baby through the vagina. A vaginal birth is merely the delivery of a baby through the vagina. A cesarean birth is the delivery of the baby through an incision in the abdomen. For the past 50 years, episiotomies were the standard of care to help women deliver. However, within the past few years, this practice has decreased in practice, and most obstetricans allow the patient to tear rather than cut an episiotomy. It heals better and avoids damage to the pelvic floor. There is always a risk of extension into the rectum (4th degree tear) which is more difficult to repair and has a difficult recuperation.