Episiotomies are not routine during childbirth but you might have needed one. We discuss episiotomy care and recovery and how to help your body heal.
What is an episiotomy?
An episiotomy is when a midwife or doctor needs to cut the area between your vagina and anus (the perineum) during childbirth, to help deliver your baby. You might have needed this if your baby had to be born quickly or if forceps were required (NICE, 2014).
It can take up to a month for your episiotomy to heal and for your stitches to dissolve. It’s important to give your body time to recover and heal (NHS Choices, 2017). Here’s how you can help yourself heal.
1. Rest when you can to promote healing
Rest is really important and will help your body recover and heal from an episiotomy. It’s a good idea to rest whenever you can and:
- It can help to lay down and air your stitches – fresh air can help with healing. Take off your underwear and lay on a towel on your bed for 10 minutes or so a couple of times a day.
- Sleep when your baby does, to help your body rest and recover.
- Talk to your midwife, health visitor or GP about which activities you should avoid while you are healing. (NHS Choices, 2017).
2. Ways to help cope with pain
It’s common to feel some pain after an episiotomy but there are things you can do to feel more comfortable. Some of the following episiotomy self-care suggestions might help to relieve pain:
- Put an ice pack wrapped in a towel or cloth onto the affected area.
- Some people say having a warm bath helps you relax and eases pain.
- Use a special doughnut-shaped inflatable cushion to help make sitting down more comfortable.
- Painkillers may also help bring relief:
- Paracetamol – is safe to use, even if you are breastfeeding.
- Ibuprofen – is safe to use if breastfeeding ONLY IF your baby wasn’t premature (born before 37 weeks), was not a low birth weight and has no medical condition.
- Aspirin is NOT recommended if you are breastfeeding because it can pass to your baby via your breastmilk. (NHS Choices, 2017)
3. Help make toilet visits more comfortable
It can be uncomfortable going to the toilet while you are recovering from an episiotomy. It’s a good idea to:
- Eat healthily and stay hydrated – this will help prevent constipation.
- Use laxatives if passing stools is particularly painful.
- Pour warm water over your vagina while you wee to help relieve discomfort.
- Pour warm water over your vagina and perineum after going to the toilet, and always wipe from front to back to keep your stitches clean.
- To relieve pressure on the wound, hold a clean pad and press lightly against your stitches while you go for a poo. (RCOG, 2015; NHS Choices, 2017)
Talk to your midwife, health visitor or GP if you have any concerns.
Other ways to aid episiotomy recovery
- Restart your pelvic floor exercises as soon as you can after birth. They enhance blood circulation and aid the healing process. It will also help reduce pressure on the cut.
- Pelvic floor exercises involve squeezing the muscles around your vagina and anus like you’re trying to stop yourself from going to the loo. You can ask your midwife for more information about this.
- Some women say it can help to talk about your birth experience with close family or friends.
- If you are worried that you aren’t healing or recovering well, talk to your midwife, health visitor or GP. (RCOG, 2015; NHS Choices, 2017)
Complications following an episiotomy
Occasionally, women experience complications after an episiotomy. It’s important to keep an eye out for any signs of infection, such as:
- red, swollen skin around the wound
- persistent pain or a smell that isn't usual for you
- pus or liquid coming from the cut. (NHS Choices, 2017)
Tell your GP, midwife or health visitor as soon as you can about any possible signs of infection, so they can make sure you get treatment.
For a few women scar tissue following an episiotomy can cause problems. Excessive, raised or itchy scar tissue can sometimes form where an episiotomy was. If your scar tissue is causing problems for you, talk to your GP.
Pain during sex
If you’ve had an episiotomy, pain during sex is common in the first few months. Most women who have an episiotomy say that having sex again after it is very painful, but that this improves with time. Read our article about having sex after having a baby.
Having an episiotomy or tear can be a sensitive subject for some women. Get medical advice if you: don’t think your stitches are healing; think you might have an infection; or are worried about your symptoms.
This page was last reviewed in August 2018
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NICE. (2014) Intrapartum care for healthy women and babies. Available from: https://www.nice.org. uk/guidance/cg190 [Accessed 16th May 2017].
RCOG. (2015) A third of fourth degree tear during birth (also known as obstetiric anal sphincter injury – OASI). Available from: https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-third--or-fourth-degree-tear-during-birth.pdf [Accessed 16th May 2017].
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RCOG. (2015) The management of third- and fourth-degree perineal tears. Available from: https://www.rcog.org.uk/globalassets/documents/guidelines/gtg-29.pdf [Accessed 16th May 2017].
Frolich, Kettle. (2015) Perineal care. BMJ Clin Evid. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356152/[Accessed 16th May 2017].
RCOG. (2016) Patterns of maternity care in English NHS trusts 2013/14. Available from: https://www.rcog.org.uk/globalassets/documents/guidelines/research--audit/maternity-indicators-2013-14_report2.pdf [Accessed 16th May 2017].