Guided Delivery: Episiotomy and Perineal Care What is an Episiotomy? An episiotomy is a strategic surgical incision made in the perineum—the muscular area between the vaginal opening and the anus—during the final stage of labor. The purpose of this procedure is to temporarily enlarge the vaginal opening, facilitating the birth of the baby and preventing irregular, spontaneous tissue tears that can be more difficult to repair. Our obstetricians perform this procedure under local anesthesia (if an epidural is not already in place) using precision surgical instruments. Once the delivery is complete, the incision is meticulously closed with dissolvable sutures designed to be absorbed by the body as the tissue heals. Why is this Procedure Personally Vital for You? An episiotomy is a clinical decision made to protect both the mother’s long-term pelvic floor health and the baby’s safety. This intervention is personally vital if: Fetal Distress is Detected: If the baby needs to be delivered quickly due to a heart rate change, an episiotomy provides the fastest path for a safe exit. An Operative Delivery is Required: If the use of forceps or a vacuum extractor is necessary, an episiotomy provides the essential space needed to apply these instruments safely. Large Birth Weight (Macrosomia): To prevent severe, uncontrolled tearing into the anal sphincter (3rd or 4th-degree tears), a controlled surgical incision is made to direct the tension away from sensitive structures. Shoulder Dystocia Occurs: In rare cases where the baby''s shoulder becomes wedged, the additional space provided by an episiotomy is critical for the obstetrician to perform life-saving maneuvers. The Path to Perineal Healing and Stability The goal of our perineal care program is to achieve "primary intention" healing—where the tissue edges knit together cleanly to restore the strength of the pelvic floor. This pathway is designed to: Provide Anatomical Reconstruction: Our surgeons use layered suturing techniques to ensure the muscles of the pelvic floor are correctly realigned, which is vital for long-term urinary and bowel continence. Ensure Clinical Readiness through Rigorous Screening: To ensure your body is prepared for the physical demands of delivery and repair, we require a full medical history, diagnostic X-rays (specifically a chest X-ray as part of the standard surgical/maternity clearance), and comprehensive blood tests (including hemoglobin levels, coagulation profiles, and inflammatory markers). A Focused Recovery and Stabilization Window: Because the perineum is a highly vascular and sensitive area, we focus on a 2–3 week recovery and stabilization period. This timeframe is essential for the initial dissolvable sutures to begin their absorption, for the reduction of localized swelling, and to ensure the pelvic floor is perfectly stabilized before you increase your physical activity levels. All details are subject to doctor evaluation for the final treatment plan.