An episiotomy, also known as perineotomy, is a surgically planned incision on the perineum and the posterior vaginal wall during second stage of labor. The incision, which can be midline or at an angle from the posterior end of the vulva, is performed under local anesthetic (pudendal anesthesia), and is sutured closed after delivery. It is one of the most common medical procedures performed on women, and although its routine use in childbirth has steadily declined in recent decades, it is still widely practised in many parts of the world including Latin America, Poland, Bulgaria, India and Qatar. Episiotomy is done as prophylaxis against soft-tissue-trauma. Vaginal tears can occur during childbirth, most often at the vaginal opening as the baby's head passes through, especially if the baby descends quickly. Tears can involve the perineal skin or extend to the muscles and the anal sphincter and anus.
Contributions by Mauro Lanari, Nandesuka, and Cazort.