3. Put your fingers into the vagina like this.
Your fingers will hold the skin of the vagina
away from the baby.
Ep isio to m y
4. Feel with your thumb to find the rectal
sphincter (the round muscle around the anus).
Never cut through the rectal sphincter.
5. Use a pair of sterile scissors to make a cut in
the skin about 2.5 centimeters (1 inch)
long. It is best to use scissors that are
rounded on the end so you will not
poke the mother or cut the baby.
There are 2 common ways to cut an episiotomy.
Use the cut that you have been trained to make.
A median cut goes
from the vagina.
This type of cut
may heal more
easily and with
A mediolateral cut
starts at the bottom
center of the vagina
and points toward
the right or left.
These cuts are less
likely to tear into
6. Feel the cut with your fingers. Cut it larger only
if you have to. It is better to make one cut than
several small cuts. Remember, do not cut into
the muscle around the anus.
7. Press on the cut with a sterile cloth
to slow the bleeding.
8. After the birth, sew the cut tissue together.
See the next few pages on sewing tears
A Book for Midwives (2010)