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What is an Episiotomy? It is when your care provider cuts                                                               your vagina area open more.

Medical literature says that a episiotomy is done because:  

1.) It will prevent a tear
2.) It opens the vaginal opening to reduce pressure on the baby’s head.
3.) An episiotomy may reduce trauma and damage to the muscles around the vaginal opening.
4.) Episiotomy shortens the 2nd stage of labor (the pushing part)
5.) A breech baby
6.) a very big baby
7.) a baby in distress

BUT most believe the following: 

1.) You will probably tear a lot more. Once the perineum is weakened with a cut, it will increase the risk of tearing about 90%.
2.) Slow pushing allows molding of the baby’s head enough to let it fit through the vaginal opening easily. Slow pushing also helps to stretch your skin around the vaginal opening. When given time, you can stretch to allow the baby to fit through.
3.) If you tear more it only increases damage to other tissue and you may actually tear into your muscles or into your rectum.
4.) Why shorten it? Who is this benefit for? Mostly it is for the benefit of the care giver, not for you. Pushing of a first-time mom usually can take from 10 minutes to 3 hours. Some care providers will sometimes allow for longer pushing time than 3 hours. Remember you should not start pushing until you have the urge. Just because you are fully dilated, does not mean you need to begin pushing. This allows your body to bring the baby down into the birth canal slowly and for more molding of the infant’s head, thus fewer traumas to baby and mother. That is much easier on you and baby than pushing all of that time. 
5.) A breech delivery can happen over an intact perineum. Sometimes the midwife/doctor may need to do one. There is more of a risk of the baby aspirating blood from the episiotomy if it is performed. (but be sure your care provider is skilled in the art of breech delivery).
6.) A very big baby, it is not the head that is stuck on the skin of the mother’s bottom (perineum) it is usually the shoulders that are stuck behind the pubic bone. An Episiotomy at this point will just allow more room for the person doing the delivery to get his/her hands inside of the mother.
7.) A baby with a rapidly dropping heart rate, and it is about to be born, by doing a episiotomy it may save the baby’s life.

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