An episiotomy is a surgical incision made in the perineum, the area between the vagina and the anus, during vaginal delivery when it's clinically indicated. It isn't done routinely for every delivery, and when it is done, what gets repaired afterward is more layered than most people expect.
What actually gets cut and repaired
The repair can involve up to three tissue layers, depending on the depth and extent of the incision:
- The mucosal layer — the vaginal lining
- The muscular layer — the underlying perineal muscles
- The skin layer — the outer covering
Not every episiotomy involves all three layers to the same degree; how deep the incision goes determines which layers actually need repair.
Why there's no fixed number of stitches
Unlike a C-section's more standardised closure, an episiotomy repair genuinely has no fixed stitch count. It depends on the depth and extent of the incision, and the type of suture, technique, and number of stitches used are decided by your doctor based on your individual case. Comparing your stitch count to someone else's isn't a meaningful comparison, since two episiotomies of different depth and extent are simply different repairs.
The number of stitches reflects your specific incision, not a standard every delivery is measured against.
When an episiotomy is actually done
An episiotomy is used when it's clinically indicated, not as a routine step in every vaginal delivery. Your obstetrician makes this call during labour based on factors like how the delivery is progressing and the baby's position, not decided in advance. If you have specific questions about why one was or wasn't done in your case, that's a conversation for your own delivering doctor, since it depends on the specifics of your labour.
Frequently asked
Does every vaginal delivery involve an episiotomy?
No. It's done only when clinically indicated during labour, not as a routine part of every vaginal birth. Whether one is needed is assessed in the moment based on how your specific delivery is progressing.
How long does episiotomy healing typically take?
Healing timelines vary with the depth of the repair and individual recovery, so there isn't one number that applies to everyone. If you have questions about healing, scarring, or recovery specific to your repair, raise them directly with your obstetrician rather than comparing to someone else's experience.
Is it normal for healing to feel different than a friend's or family member's episiotomy?
Yes, this is expected rather than unusual. Every delivery and every repair is individual, since the depth and extent of the incision and the tissue layers involved genuinely differ case to case. If anything about your healing concerns you, that's worth raising with your doctor rather than measuring it against someone else's recovery.