But older women currently having repair surgery for incontinence and prolapse all had generous episiotomies. In any case, episiotomy is not done until the head is almost ready to be born. By then, the pelvic floor muscles are already fully distended. Nor has anyone ever explained how cutting a muscle and stitching it back together preserves its strength. A woman's perineum is soft, elastic tissue, not concrete.
Infections are painful.
Sutures must be removed to drain the wound, and later the perineum must be restitched. Moreover, there are two extremely rare gangrenous infections called necrotizing fasciitis and clostridial myonecrosis reported in the literature. These infections kill many of the women who contract them and maim the survivors. While these infections are rare, they make a substantial contribution to maternal mortality. A fourth woman survived, spending 23 days in the hospital.