Where is an episiotomy usually done?

Btwn vagina and anus: An episiotomy is a surgical incision performed by a doctor during childbirth. The delivering physician will make a cut that extends the vaginal opening further toward the anus. This is only done if the baby may be too large to be delivered through the vaginal opening, to prevent tearing of the tissue. An apisiotomy allows the doctor to repair the tissue after birth so it heals more easily.

In delivery room: If needed, it is best if a surgical procedure (like epis) is performed under sterile or the cleanest conditions possible. That would typically be in a dr after a woman's perineum ('bottom') has been cleaned with an antiseptic solution and local anesthesia has been given. Sometimes, however, mother nature does not wait so episiotomy and delivery are carried out in nonsterile but clean conditions.