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An episiotomy is a minor surgical procedure where the skin and underlying muscles of the perineumâthe area between the vagina and the rectumâis cut at the end of the second stage of labor (crowning) to assist in childbirth by enlarging the birth canal opening and allowing the baby to pass through more easily.n episiotomy is a minor surgical procedure where the skin and underlying muscles of the perineumâthe area between the vagina and the rectumâis cut at the end of the second stage of labor (crowning) to assist in childbirth by enlarging the birth canal opening and allowing the baby to pass through more easily.