How might an episiotomy affect your birth experience and postpartum recovery?
You can expect some discomfort in the first few days after childbirth even if you have not had an episiotomy. It is common for there to be some general soreness or even a small injury to the perineum. However, having an episiotomy will greatly increase your chances of having enough pain to interfere with walking or sitting comfortably. This can hinder breastfeeding and caring for your baby. You may also experience intense stinging with urination and moving your bowels can be very uncomfortable for the first few days.
If you are unfortunate enough to have one of the complications of episiotomy -- it extends or infects -- you could be looking at a prolonged period of pain, or problems such as anal incontinence that could seriously or even permanently affect your quality of life, especially in having sexual relations.
The harm done by episiotomy may also not show up immediately. Urinary and anal incontinence may only begin years later when aging and further childbearing add to the toll taken by episiotomy.
What is a reasonable episiotomy rate?
Two literature reviews have recommended 20 and 30 percent as maximum rates (14, 20); however, practitioners who try to minimize their use of procedures such as episiotomy commonly have rates much lower than this.
In a study of homebirth, one percent of women with prior births had an episiotomy, and among first-time mothers, who are often thought to be more likely to need one, two percent had the procedure (17). More than two-thirds of the women had no genital injury, or an injury so minor that no stitching was needed.