An episiotomy is a small cut between the vagina and the anus to enlarge the opening of the vagina during childbirth. The decision to perform an episiotomy will come at the time of delivery. In some cases, an episiotomy may be needed if the baby is  breech, the baby’s head or shoulders are too large, or if there is a problem during delivery. The area will be stitched after delivery and should heal within 4 to 6 weeks.