An
episiotomy ( or ), also known as
perineotomy, is a surgical incision of the
perineum and the posterior vaginal wall generally done by a
midwife or
obstetrician during second stage of labor to quickly enlarge the opening for the baby to pass through. The incision, which can be done at a 90 degree angle from the
vulva towards the
anus or at an angle from the posterior end of the vulva (medio-lateral episiotomy), is performed under
local anesthetic (
pudendal anesthesia), and is
sutured closed after delivery. It is one of the most common medical procedures performed on women, and although its routine use in childbirth has steadily declined in recent decades, it is still widely practiced in many parts of the world including
Latin America,
Poland,
Bulgaria,
India and
Qatar.