Episiotomy was though to prevent uncontrolled, jagged tears during delivery by artificially enlarging the external vaginal opening. In some women, the external opening of the vagina will stretch to accommodate the baby's head.
Vaginal opening was anesthetized with a local anesthesia (unless the mother has already had an epidural), and a scissors was used to cut into the space. The cut could be either straight up and down (median episiotomy), or, if the baby was very large or the space very short, the cut was made off to one side (mediolateral episiotomy), to avoid damaging the anal sphincter.
After delivery, the episiotomy is closed in layers with absorbable sutures. There is no need to remove stitches later on because they dissolve and are absorbed..
It is helpful when forceps are used to aid delivery in the second stage. Forceps are relatively large, and to use them properly, an episiotomy is needed.
Shoulder dystocia could also occur when the baby's head is born, but the shoulders become wedged behind the mother's pelvic bone.
The other major reason is to prevent urinary incontinence,as women age,the tissues in the pelvis relax and feel difficulty in holding urine.
Unfortunately, that is not the case, it is the stretching of the ligaments inside the pelvis that probaly lead to weakening and problems with holding in urine.Because of the lack of benefit, and, indeed, an increased risk of tearing, episiotomy should now be used only in specific situations and not for uncomplicated vaginal deliveries.
