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Types of Episiotomies

There are many types of episiotomies and if you need one, the method used on you will depend on the situation and your doctor’s preferences. Episiotomies differ in the direction and depth of the incision, but all are approximately 2½ cm. long.

The 4 possible directions are:

  1. A median/midline incision: the perineum is cut directly towards the rectum.
  2. A medio-lateral incision: the perineum is cut at a 45º angle away from the vagina either towards the left or the right. Currently, this is the most popular method.
  3. A lateral incision: many risks are associated with this method, so talk to your physician before labour to check that he does NOT use this method.
  4. A J-shaped incision: the name says it all, a midline incision is cut for about 1.5 cm. and then either curves to the left or right to make a J-shape. This method is not common.

The 4 possible depths/degrees are:

  1. First degree: only the skin on the perineum is cut.
  2. Second degree: the skin and underlying tissue of the perineum is cut.
  3. Third degree: the skin, underlying tissue and anal sphincter is cut.
  4. Fourth degree: the skin, underlying tissue, anal sphincter and rectal mucosa are cut.

Your physician will try to keep your incision as shallow as possible so that your recovery period is shorter and more comfortable for you.

Is there anyhting I can do to avoid an episiotomy?

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