Episiotomy or Perineal Tear

An episiotomy is an incision made in the tissue between the vagina and anus ( perineum ). It is sometimes done just before a baby's head emerges from the birth canal to speed up delivery of the baby. The incision is stitched up after delivery. Episiotomies are more commonly used during first-time deliveries.

Routine episiotomy is not recommended. Experts say that episiotomy: footnote 1

  • Usually is not needed, especially during routine deliveries.
  • Does not tend to heal faster than a perineal tear and typically causes more pain.
  • Can cause more damage to the muscles around the vagina and rectum than a tear does.

There are times when an episiotomy is urgently necessary. The decision about whether to have an episiotomy cannot be made until delivery. If your health professional decides that an episiotomy is necessary, it will be just before delivery.

Rather than discuss episiotomy during delivery, it's a good idea to go over it with your health professional at one of your prenatal visits.


  1. Agency for Healthcare Research and Quality (2005). The Use of Episiotomy in Obstetrical Care: A Systematic Review. Evidence Report/Technology Assessment No. 112. Available online: //www.ahrq.gov.

ByHealthwise Staff

Primary Medical Reviewer Sarah Marshall, MD - Family Medicine

Specialist Medical Reviewer Kirtly Jones, MD - Obstetrics and Gynecology

Current as ofMay 20, 2016