The truth about episiotomy vs. natural tear

OBGYN Lauren Hyman, MD, explains the truth about episiotomy and natural vaginal tearing during labor, and when a doctor may elect to perform an episiotomy
The Difference Between Episiotomy and Natural Tear During Labor
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The truth about episiotomy vs. natural tear

Episiotomy is a surgical incision between the vagina and the rectum in an area called the perineum. It used to be performed very regularly, it was felt to help protect the bladder and the rectum by performing an episiotomy. You would tear down rather than tear up and possibly heart the urethra or the labia. And it was felt that it helped to speed labor alone. The trends have changed in the last 20 years and these days the most practitioners feel the tear naturally is a lot safer than having an episiotomy performed. Now that being said, there are certainly many cases where doctor would preferred to perform an episiotomy and some instances might be when the doctor needs a little bit more room to manipulate the baby’s head or shoulders in a difficult birth or when the baby needs to be delivered very rapidly perhaps because of a rapid heartbeat drop and the perineum doesn't have time to stretch out, in these cases the doctor might perform an episiotomy as suppose to letting the women’s perineum tear naturally . Also when a case the doctor might feel that a tear would much more extensive than an episiotomy would be the doctor may elect to perform an episiotomy. Both a repair and an episiotomy are sewn up in much the same ways. Stitches are used and they dissolve within 4 to 6 weeks and are checked at the women’s 6 weeks postpartum appointment. There are something’s women can do in their labor process to help minimize tearing and those can include one compressors on the perineum and also stretching the perineum during the second stage or pushing stage of labor using mineral oil or lubricant at the end of the day. The mother’s anatomy and the baby’s head size and position will often determine the type of tear or for episiotomy is necessary. Hind side is sometimes 20/20, sometimes the doctor will wish she had performed an episiotomy after the delivery when a tear is very extensive or a tear would be much more minimal than the doctor would have predicted. Most first time mom does end up tiring, if they don’t receive an episiotomy. The honest truth is tearing or with an episiotomy they get sewn up in much the same way and it’s very rare in either case to have complication. Both usually heal up quite beautifully.

OBGYN Lauren Hyman, MD, explains the truth about episiotomy and natural vaginal tearing during labor, and when a doctor may elect to perform an episiotomy


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Lauren D. Hyman, MD

Obstetrician Gynecologist

Dr. Lauren Hyman is a board-certified obstetrician gynecologist. After receiving her ScB from Brown University and her medical degree from Yale University, Dr. Hyman returned to Southern California where she has been in private practice in the West Hills area for fifteen years. She can be seen weekly on Hallmark Channelʼs Home and Family Pregnancy Series and is a contributing writer on She lives with her husband and two children in Los Angeles.

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