An episiotomy is a procedure carried out sometimes during labour to make it easier to deliver the baby if it is in foetal distress, needs to be born more quickly or there is another clinical reason, such as a forceps or ventouse suction delivery.
The need for an episiotomy will be discussed with the mum-to-be before it goes ahead.
Reasons for episiotomy include having a large baby, a breech birth - where the baby comes out bottom first rather than head first - or having unusually weak skin with a risk of tearing.
Local anaesthetic is given or a top-up to epidural pain relief. Then, a doctor or midwife makes a cut in the area between the vagina and anus, called the perineum, to make the opening of the vagina wider.
The cut is repaired with dissolving stitches after the birth. This should heal in around a month, but may feel painful for several weeks after the delivery.
The cut may sting when passing urine. Another after effect of an episiotomy is sex sometimes feeling painful for a few months afterwards.
Advice will be given on appropriate painkillers when breastfeeding, such as paracetamol.
Pain may also be relieved by putting an ice pack wrapped in a towel on the incision area. Sitting on a special ring-shaped cushion or squeezing the buttocks together while sitting down may be recommended.
Advice will be given on keeping the area clean and on looking out for any signs of infection around the cut, as well as the importance of trying to let air get to the wound as it heals.
Some scarring may remain where the episiotomy took place.