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    oxybutynin
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    EPISIOTOMY COMMON
    But not always necessary

    For decades, having an episiotomy seemed almost a routine part of having a baby. During the final stages of labor, the attending physician enlarges the opening of the birth canal by making an incision (episiotomy) in the skin and muscles between the vagina and rectum (the perineum). Pain control for the episiotomy is commonly provided by an injection of anesthetic to numb the area.

    Pros and cons of an episiotomy

    Episiotomy is meant to ease delivery as well as avoid possible tearing and jagged lacerations that might otherwise occur. Episiotomy is also expected to prevent problems such as urinary or fecal incontinence or prolapse (descent) of the uterus.

    Episiotomies are still performed on the majority of first-time mothers in the United States, although most doctors now wait until the top of the baby's head appears at the vaginal opening (crowning) to decide whether the procedure is necessary.

    But if it hasn't worked up to expectations, why the continued use?

    In other situations, an episiotomy may be more than a matter of preference. An episiotomy may be necessary to complete the birth quickly in certain situations, for example:

    Premature and other fragile babies can be spared some of the pressure of stretching the perineum.


    Certain birth situations (large baby, breech baby and others) require an episiotomy for the safety of the baby.


    The mother isn't able to stop pushing. She may be almost frantic, unable to slow down and wait another 45 minutes to an hour.


    The doctor determines the use of forceps or vacuum extraction is needed.



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