Episiotomy—the small surgical incision made to enlarge the vaginal opening shortly before a baby is delivered—was not a commonly accepted birth procedure until the twentieth century. But by mid-century, over half of vaginal deliveries included an episiotomy. The idea was that making a small incision would reduce the risk of a large spontaneous tear in the tissues surrounding the vagina (the perineum), as the infant’s head delivered.
As physicians, we want to offer our patients only medical interventions that—based on solid evidence—actually benefit them. By the 1980s, we began to realize that the medical benefits of routine episiotomy were uncertain. According to recent data, less than 12% of women delivering vaginally now have an episiotomy. We do not consider episiotomy a routine part of childbirth. Read more