If I had an episiotomy for my first child, do I need to have an episiotomy for my second child? Do I need to have an episiotomy at the same place for my second child?

If you had an episiotomy for your first child, do you need to have an episiotomy for your second child? This is a question that all parents who have had a normal birth need to face. So, for mothers who had an episiotomy for their first child, do they need to have an episiotomy for their second child? Let's talk about episiotomy in detail.

If I had an episiotomy for my first child, do I need to have an episiotomy for my second child?

After the vagina of a multiparous woman has expanded, it will be easier to give birth than the first child, and the chance of episiotomy will also be reduced. However, if the following situations occur, episiotomy will still be required for the second child in order to reduce damage to the mother and newborn.

1. The fetal head is too large to avoid severe perineal laceration. If the fetus is large and the delivery is fast, deep perineal laceration may occur, which may even affect urination and defecation after delivery, and the pelvic floor and vagina will be stretched more loose, affecting recovery. Episiotomy can reduce the expansion of the birth canal by the fetal head and protect the mother's pelvic floor and vagina to a certain extent.

2. Older mothers or those with complications during pregnancy. For older second-time mothers over 35 years old, or those with complications such as heart disease and pregnancy-induced hypertension syndrome, episiotomy is performed to shorten the second stage of labor and reduce the harm to the mother and child in order to avoid the mother exerting too much force for a long time.

3. Prevent danger to the baby and complete the delivery process as soon as possible. If the fetal head is under great pressure from the perineal tissue for a long time, it is likely to cause fetal asphyxia or intracranial hemorrhage. In order to shorten the time the fetal head is squeezed at the vaginal opening and to get the fetus out of the danger of hypoxia as soon as possible, episiotomy is required. In addition, if the fetal head is relatively large and the mother's pelvic condition is not good, and a suction device or forceps is needed for delivery, episiotomy is also required to cooperate with the final delivery.

Will episiotomy be performed for the second child born naturally?

My first child was born naturally, but the doctor made a small incision on my vulva during delivery, saying it was to facilitate natural delivery. Now my husband and I are preparing to have another baby, but I have some doubts: If I don’t choose cesarean section, and I had an episiotomy for the first child, do I need to do it again for the second child?

Wen Jiying, chief obstetrician at Guangdong Provincial Women and Children's Health Care Hospital, said that the professional term for making a small incision in the vulva to facilitate childbirth is "episiotomy and suture". It is a surgery to enlarge the vulva opening during childbirth in order to allow the fetus to come out smoothly, with the purpose of reducing birth injuries to mother and baby.

For multiparous women, since the birth canal is relatively loose after the previous vaginal delivery, no matter whether an episiotomy was done during the first delivery, there is no need to do it again when giving birth to the second child!

According to a survey, about 30% of pregnant women in my country need episiotomy, and the chance is even smaller for a second child. At the same time, doctors will not require women to have a cesarean section or episiotomy without medical indications, so there is no need to worry too much.

Should I still cut my episiotomy at the original location when I have my second child?

If the vaginal opening is relatively small when giving birth to the second child, the fetal head has not been delivered, and the perineum has been torn, a vaginal episiotomy should be performed. In order to minimize scarring, the episiotomy is still at the original episiotomy site. But generally speaking, there is no need for an episiotomy for the second child, because the birth canal is relatively loose after the previous vaginal delivery, which greatly reduces the difficulty of the second delivery.

The purpose of episiotomy is to prevent complex lacerations of the soft tissue at the vaginal outlet during delivery, especially when the fetal head is delivered quickly. Once a serious tear occurs, it can cause pelvic floor dysfunction and even damage the anal sphincter and levator ani muscles, resulting in fecal incontinence, which is difficult to repair. Episiotomy can speed up delivery, avoid aggravating fetal distress and neonatal asphyxia, and is also beneficial to the recovery of pelvic floor function after delivery, reducing the incidence of bladder and rectal prolapse and stress urinary incontinence.