One common reason for carrying out an episiotomy is when it is necessary to widen your vagina so that instruments, such as forceps or suction, can be used to assist with the birth.
This may be necessary if:
- you are having a breech birth – the baby comes out of the vagina feet first
- your baby’s shoulder gets stuck inside your vaginal region
- you have been unsuccessfully trying to give birth for several hours and are now extremely exhausted
- you have a serious health condition, such as heart disease, and it is recommended that labour should be as quick as possible to minimise any further health risk
Foetal distress
An episiotomy may also be recommended if your baby develops a condition known as foetal distress.
Foetal distress is where the baby’s heart rate significantly increases or decreases before birth. This means that the baby may not be getting enough oxygen and has to be delivered quickly to avoid the risk of birth defects or stillbirth.
If a caesarean section is not appropriate – for example, because the baby's head is already moving down the birth canal, an episiotomy can be the best way to speed up birth.
Scarring
An episiotomy may also be recommended if there is extensive scarring to your vagina due to a severe tear in the perineum after a previous birth.
