Three key risks associated with an episiotomy are infection, severe perineal tearing, and long-term pain, including painful sex.
Like many historical shifts in doctor opinion, data drives why we no longer recommend routine episiotomies. The No. 1 reason the procedure has fallen out of favor is that it actually contributes to worse tearing than might occur naturally during childbirth.
Using ice packs or sitting in warm water (a sitz bath) several times a day may also help with pain. Most women say they have less pain or discomfort after the first week. Most episiotomies heal in 3 weeks. But it may take longer.
Call your midwife or GP if you've had an episiotomy or tear and: your stitches get more painful. there's smelly discharge. there's red, swollen skin around the cut (incision) or tear – you can use a mirror to have a look.
But you may be wondering whether you'll heal faster after having an episiotomy or a natural tear during labor. Natural tears usually heal faster than episiotomies. Compared to an episiotomy, natural tears usually mean less pain, fewer complications, and quicker recovery. Episiotomies aren't routine anymore.
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.
Usually, when the healing process is complete, there will be a red scar for a short while. This will eventually fade like any skin scar. Re-sutured wounds heal a bit faster but there is a small risk that it will become infected again.
33% of the women who had an episiotomy in a previous birth, went on to have either a 1st or 2nd degree tear. Compared to 17% of women who had not had a previous episiotomy.
If you've had a perineal tear or episiotomy, sitting directly on your perineum might feel uncomfortable as it heals. TRY THIS TIP: Fold two small towels and place them under your sit bones (the bony parts of your bottom).
Compared with a natural tear, an episiotomy is generally more painful, it leads to blood loss and takes longer to heal. There are two types of episiotomy incisions: Midline incision. A midline incision is done vertically.
Avoiding an Episiotomy
During the last month or two before your due date, perform Kegel exercises and perineum massages to strengthen and stretch the muscles of the pelvic floor. Making Kegels a part of your daily routine can make labor and post-birth recovery easier. Read about how to practice Kegel exercises here.
Routine episiotomies are no longer recommended. Still, the procedure is sometimes needed.
After a vaginal birth, most pain from tears or soreness improves within one to two weeks, though mild discomfort may last a bit longer. After a C-section, incision pain can persist for weeks, with some women feeling tenderness or numbness for months.
The procedure, used liberally after its introduction in the 1950's, was thought to prevent severe perineal tearing and long-term pelvic floor damage [2]. However, episiotomy became increasingly controversial as growing evidence demonstrated that its routine use caused worse perineal and vaginal trauma for women [3, 4].
Patients with episiotomy in the index birth higher rates of subsequent episiotomy (17.5 vs. 3.1%; P < 0.001; OR 1.9; 95% CI). In addition, the rates of the first and second degree perineal tears as well as the third and fourth degree perineal tears were significantly higher in patients following episiotomy (33.6 vs.
Long-term effects of episiotomies can include: Chronic pain and infections. A small linear scar. Anorectal dysfunction.
A second-degree tear is deeper. The tear is more than one finger width deep, extending into the muscles of the perineum but does not involve the anal sphincter.
Pour warm water over the vulva and perineum after going to the toilet. Always pat or wipe from front to back to keep stitches clean. To relieve pressure on the wound, hold a clean pad and press lightly against stitches while going for a poo. Use a stool softener if passing stools (pooing) is particularly painful.
As we've discussed, it's totally normal for your vagina to become looser after giving birth. If you're uncomfortable with this and want to help tighten it again, there are several ways to help strengthen your vaginal floor muscles.
You can do many other things to help speed up the healing process, such as: Use sitz baths (sit in water that covers your vulvar area) a few times a day. Wait until 24 hours after you have given birth to take a sitz bath as well. You can buy tubs in any drug store that will fit on the rim of the toilet.
Increased bleeding after your lochia starts to decrease can be a sign you're overdoing it and need more rest. Seeing ongoing clots could mean your uterus is having trouble getting back to its pre-pregnancy size. In either case, it's always best to call.
You may like to add 3 to 4 drops of lavender or chamomile essential oil to the jug of warm water which can soothe the area and promote healing. After passing urine, pat dry with clean toilet paper. Change sanitary pads each time you go to the toilet to reduce the chance of infection.