One type is where the doctor cuts straight down from the vaginal opening. Another type is where the doctor cuts at an angle from the vaginal opening. This later incision is usually more preferred by doctors because of its ability to prevent further tearing from the incision. The straight down cut may lead to tearing further down and possibly into the rectum. Many women fear the thought of being cut in such a sensitive area.
Some doctors routinely do an episiotomy to prevent tearing.
An episiotomy does heal much faster than a tear. Other doctors will wait until the baby's head begins to emerge and watch for any signs of tearing. Some women do not need to have an episiotomy. During labor, the doctor will usually perform the incision before the pushing stage to prevent tearing. Or, they may wait to check for signs of tearing and perform the incision during the pushing stage.