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Episiotomy

Episiotomies, care of your stitches and what to expect when healing

How does an episiotomy differ from a tear?

A tear happens spontaneously as the baby stretches the vagina during birth.

An episiotomy is a cut made by a healthcare professional into the perineum and vaginal wall to make more space for your baby to be born. It is possible for an episiotomy to extend and become a deeper tear.

Episiotomies are only done with your consent.

If you have had an episiotomy, you will need stitches to repair it. This is normally done using local anesthetic in the room where you had your baby.

 

Why do some women have an episiotomy?

A healthcare professional will do an episiotomy if you are having an instrumental (or assisted) vaginal birth.

An instrumental (assisted) vaginal birth is when forceps or a suction cup (ventouse or kiwi) are used to help your baby to be born.

Suction cups and forceps are safe and only used when necessary for you and your baby.

Instrumental birth is less common in women who have had a spontaneous vaginal birth before.

An episiotomy may also be done if your baby needs to be born quickly, or if you at risk of a serious perineal tear.

 

How do I care for my episiotomy and reduce my chance of infection?

It is important to keep the area clean. Only use water to wash.

Wash or shower at least once a day, and change sanitary pads regularly.

Wash your hands both before and after going to the toilet or changing your sanitary pads. This will reduce the risk of infection.

You should drink at least 2 litres of water every day and eat a healthy balanced diet (for instance: fruit, vegetables, cereals, wholemeal bread and pasta).

This will help your bowels open regularly and avoid constipation.

 

How long should it take for my wound to heal?

After having an episiotomy, it is normal to feel pain or soreness for 2-3 weeks after giving birth, particularly when walking or sitting.

The stitches can irritate as healing takes place but this is normal. Pouring body-temperature water over the area when urinating can help.

Passing urine can cause stinging.

The skin part of the wound usually heals within a few weeks of birth, and after that you should feel much less raw and tender.

 

Should my wound hurt after it has healed?

The skin part of the wound usually heals within a few weeks of birth, and after that you should feel much less raw and tender.

 

Will I need an episiotomy in future births?

No. The need for an episiotomy is assessed at the time of birth. It is always dependent on your wellbeing and that of your baby.

A few women will have excessive scar tissue from a previous episiotomy and because scar tissue does not stretch these women may need a repeat episiotomy to prevent excessive tearing.

 

When should I contact a healthcare professional?

  • If your stitches become painful.
  • If your stitches become smelly.
  • If your wound does not heal.
  • If you have any problems controlling your bowels, for instance you struggle to make it to the toilet or control wind.
  • If you have any concerns.

 

Further reading

 

 

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A–Z of common medical words in women’s health
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