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An episiotomy is a small cut made in the perineum (the area of muscle between the vagina and the anus) to enlarge the vaginal opening for childbirth. Episiotomy is usually performed just before the baby is born when the head is placing pressure on the perineum. Because the pressure of the baby's head creates a natural numbing effect, most women do not feel much pain from episiotomy even in an unmedicated birth. However, you may feel a variety of sensations such as pulling or pressure. Once the baby is born, the doctor will give you a few stitches to ensure the cut heals properly. Doctors typically use a topical anesthetic so that receiving the stiches will not be painful.