Episiotomy vs Tearing: Which is Better?

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Episiotomies have been a common practice by obstetricians for years, although a lot of research over the past few decades has found this practice isn’t as helpful as once believed. Episiotomies occurred in 2 out of every 3 births in the late 1970′s, although today only 1 in 5 births require the procedure. So, is it better to have an episiotomy or tear naturally? Here’s a more in-depth look.

Episiotomy vs Tearing: What Research Shows
Obstetricians used to routinely perform episiotomies to assist in a fast delivery and prevent tearing, believing that this clean incision would heal better than a tear in the skin. Experts also thought episiotomies would cause fewer complications as well. Research over 20 years has shown quite the opposite, however, and there has been no evidence to show episiotomies offer any benefit.

Potential Risks with an Episiotomy
Episiotomies carry a number of risks. While episiotomy vs tearing healing time is about the same, women who have an episiotomy are more likely to have complications, including blood loss during labor and increased pain during recovery. It’s also necessary to wait longer to have sex comfortably after an episiotomy. The procedure carries a much higher risk of infection and has been shown to increase the chances of tearing during the next birth. Women who have an episiotomy are also more likely to have a severe tear that goes to the anal sphincter or into the rectum. These severe 3rd and 4th degree lacerations can also lead to anal incontinence in some cases.

When is an Episiotomy Better?
There are some situations in which an episiotomy is necessary. If you’re having a large baby and your doctor needs more room to use forcepts, an episiotomy is usually a good decision. An episiotomy may also be medically necessary if your baby requires an immediate delivery because they aren’t dealing with the end of labor well and your doctor is concerned for their health.