Episiotomy

Episiotomy
Medio-lateral episiotomy as baby crowns
Pronunciation	/əˌpiːziˈɒtəmi, ˌɛpəsaɪˈ-/
Other names	Perineotomy
Specialty	obstetrics
ICD-9-CM	73.6
MeSH	D004841
MedlinePlus	002920
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Episiotomy, also known as perineotomy, is a surgical incision of the perineum and the posterior vaginal wall generally done by an obstetrician. This is usually performed during the second stage of labor to quickly enlarge the aperture, allowing the baby to pass through. The incision, which can be done from the posterior midline of the vulva straight toward the anus or at an angle to the right or left (medio-lateral episiotomy), is performed under local anesthetic (pudendal anesthesia), and is sutured after delivery.

Its routine use is no longer recommended, as perineal massage, a form of the plastic surgeon's principle of 'skin tissue expansion' applied to the vaginal cavity, is an alternative painless method of enlarging the orifice for the baby.^[1][2][3] It is nonetheless one of the most common surgical procedures specific to women. In the United States, as of 2012, it was performed in 12% of vaginal births.^[1] It is still widely practiced in many parts of the world, including Korea, Japan, Taiwan, China, and Spain.^[4][5]