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How an episiotomy is performed

An episiotomy is usually a simple procedure carried out in 3 stages:

  • pain relief
  • the incision (cut)
  • repair

Pain relief

Your midwife or obstetrician will give you an injection of local anaesthetic to numb the area around your vagina. This is so you will not feel any pain.

If you have already had an epidural, the dose can be 'topped up' before the episiotomy is done.

The incision (cut)

Your midwife or obstetrician will usually make a small cut. This will be from the back of your vagina. The direction of the cut is usually diagonal, down and out to 1 side.

diagram shows location of the bum and vagina, where the baby's head will come out and the possible area between the bottom of the vagina and top of the bum where a cut may be made
Possible episiotomy angles


After your baby has been born, your midwife or obstetrician will stitch the cut back together using dissolvable stitches.

After an episiotomy

Most episiotomies will be stitched within 1 hour of your baby’s birth. You may have some bleeding at the time of the episiotomy but this should stop once the stitching has been done.

It can take up to a month for the cut to heal and for the stitches to dissolve. During this time, you may feel some pain.

Page last reviewed: 21 February 2023
Next review due: 21 February 2026