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Episiotomy - why you might need one

Your vagina and your perineum (the area between your vaginal opening and your anus) are very stretchy. During the birth of your baby, they need to stretch to allow your baby to be born.

Sometimes, during the birth, your midwife or obstetrician will need to make a cut in your perineum to make the opening at your vagina bigger. This is called an episiotomy.

The cut will be stitched up by your midwife or obstetrician after the birth.

Episiotomies are not carried out routinely in Ireland. This means that episiotomies are not done during every labour, only when needed.

They are done if extra help is needed to birth the baby or to prevent the muscles and skin from tearing. Episiotomies are more common with first-time vaginal births.

Reasons for an episiotomy

You might need an episiotomy if:

  • your baby’s heart rate is beating too quickly or too slowly (sometimes called “fetal distress”) - this could be a sign that your baby is not getting enough oxygen
  • your obstetrician or midwife need to make the opening at your vagina bigger - this might be needed if they are going to use instruments like forceps or a ventouse to help with the birth
  • you are having a breech birth – this means the baby is coming bottom or feet first
  • your baby is big
  • you have certain medical conditions, such as heart disease, and your doctors have recommended that your labour be as speedy as possible
  • you have been pushing for a while and are exhausted
  • it is needed to prevent a third-degree tear

Third-degree tears

A third-degree tear is a tear of the muscles in your perineum that also affects muscles of your anus (back passage).

Some research has found that doing an episiotomy during certain types of birth, such as forceps births, reduces the risk of a third-degree tear.

page last reviewed: 19/06/2019
next review due: 19/06/2022