09/07/2026
"Nobody told me they were about to cut me. I found out when I felt the stitches afterward."
That's how a lot of mothers describe their episiotomy... a surgical cut made to the perineum during birth, done in the final seconds of pushing, when there's no time left to ask, explain, or even mention it before it's already done.
For decades, this was routine. Nearly every first-time mother, cut "just in case," whether she needed it or not.
Here's what almost nobody was told: the evidence never actually supported that.
Routine episiotomy doesn't reduce the risk of severe tearing, in many cases, it increases it.
A natural tear tends to heal better and cause less long-term pain than a surgical cut in that same spot.
Both ACOG and the WHO now recommend restrictive use — meaning it should happen only when there's a genuine medical reason, not as a default step.
I want to be fair here, because this isn't a case against the procedure itself.
Sometimes it might be the right call. The problem was never the tool. It's that it became a habit instead of a decision.
If you've had this happen to you, I want you to know something clearly: it wasn't in your head, and you weren't overreacting.
Finding out about something done to your body after the fact is not a small thing, even when the outcome was fine.
You are allowed to ask, before you're ever pushing: "what's your episotomy rate?" One sentence, asked in advance, means the next time it's your body on that table, you're not finding out after.
This is exactly the kind of specific, easy-to-miss line we help you write into your birth plan — the questions almost nobody thinks to ask until it's already too late to ask them.
Comment PLAN and we'll send the guide straight to your DMs. 🤍
Did this happen to you without being told first? You're not alone — tell me below.