Last updated: 02/17/2009

An episiotomy is usually done during the birthing process in order to deliver a baby without tearing the perineum and surrounding tissue. Reasons for an episiotomy include:

• Evidence of maternal or fetal distress (i.e. no time to allow perineum...
  
  to stretch).
• The baby is premature or in breech position, and his/her head could be damaged by a tight perineum.
• The baby is too large to be delivered without causing extensive tearing.
• The delivery is being assisted by forceps.
• The mother is too tired or unable to push.
• Existing trauma to the perineum.

Some experts believe that an episiotomy speeds up the birthing process, making it easier for the baby to be delivered. Speed can be important if there is any sign of distress that may harm the mother or baby. Because tissues in this area may tear during the delivery, another reason for performing an episiotomy is that a clean incision is easier to repair than a jagged tear and may heal faster. Although episiotomies are sometimes described as protecting the pelvic muscles and possibly preventing future problems with urinary incontinence, it is not clear that the procedure actually helps.