A recent report says hospitals are performing too many episiotomies — some with rates as high as 20-40% of births.

Episiotomy is a surgical incision made to enlarge the vaginal opening during childbirth. This incision often heals more slowly than natural tearing and can have lasting physical and emotional effects.

While it is safe to assume most women would want to avoid this procedure, some report feeling especially ill-informed and pressured during the experience. Sometimes, the experience can be traumatic enough to induce lasting fear about future pregnancies and childbirth.

For many years, doctors were taught that episiotomies are a routine procedure that can reduce complications of childbirth and tearing. Unfortunately, this mindset has been difficult to change, despite a lack of evidence to support the practice. There are few emergency cases where an episiotomy might be necessary. These cases are the exceptions, not the norm.

There is no evidence to support the routine use of episiotomy, so it is difficult to establish an “acceptable” rate of use, but some sources suggest the goal should be 5% of births or less. Hospitals are not required to publicize their episiotomy rates, making it hard to know exactly how often the procedure really occurs.

Episiotomy is not routinely used at Best Start Birth Center and we are proud to openly report our statistics. Since 2014, our midwives have only performed one episiotomy. We are skilled in helping mothers stretch naturally and encourage birthing positions that reduce the need for episiotomy.

Best Start is committed to using evidence-based practices and ensuring mothers have positive birth experiences. Evidence shows midwifery-led care results in excellent outcomes with fewer interventions, preterm births, fetal and newborn deaths; no adverse effects and higher satisfaction.