An episiotomy is the incision of the perineum and/or labia to aid delivery. There are two types:

1. Midline: The incision is made in the midline from the posterior fourchette. Most common.

2. Mediolateral: The incision is oblique starting from 5 o'clock or 7 o'clock position of the vagina. Causes more infection and pain.


■ Risk of perineal rupture

■ Shoulder dystocia

■ Breech delivery

■ Forceps/vacuum delivery

Proper repair of 4th-degree laceration is important to prevent future maternal problems (e.g., fecal incontinence).

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