First, researchers now believe that instead of protecting against tears, an episiotomy may actually provide the starting place for one. Furthermore, the most recent data from the University of Ottawa found that compared to those without an episiotomy, women with the incision experienced more bleeding, pain, infections, and the lowest levels of sexual satisfaction after three months. Moreover, a study in the January issue of the British Medical Journal found that compared to natural tearing, episiotomies tripled the risk of a woman suffering some loss of bowel control. Pelvic-floor exercises like Kegels or using weighted vaginal cones can help improve muscle tone in the anal sphincter, alleviating symptoms, but when such measures fail, surgery may be required. Intercourse was painful for months.
Some episiotomies can also lead to chronic pain.
If they don't heal properly, they can cause muscle tension and chronic pain in a small number of women, Dr. Schoon says. Because many practitioners will continue to perform episiotomies despite the recommendations, it's important to discuss your doctor's or midwife's position on the procedure well before you go into labor, preferably at one of your first visits. If you have a birth plan, your wish to avoid an incision unless absolutely necessary can be a part of it. If you are uncomfortable with your doctor's stance, don't hesitate to switch to one whose ideology matches yours. It can also help to remind your practitioner of your desire when you get to the hospital.