Is an episiotomy really necessary?

With skilled guidance during the delivery (and dependent on your skin’s natural elasticity), an episiotomy should not normally be necessary for a routine birth, and in New Zealand it generally isn’t. Appropriate reasons for an episiotomy are to speed up delivery when the baby is in distress (e.g. prolonged heart-rate decelerations), and as part of facilitating an instrumental vaginal delivery. Mums who need to undergo this will be given a local anaesthetic and it’s normally fairly painless.