After an episiotomy is performed, your doctor or midwife will repair the perineum by stitching the wound closed. The stitches are often black but can be other colors or be clear. You will probably be able to see them if you look at the area between your vulva and anus.
The new tissue may look red and may bleed a little. 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.
You shouldn't feel anything during an episiotomy. Your obstetrician uses a local anesthetic (typically injected into the area) to numb your perineal area so you don't feel pain. In some cases, you've already had an epidural and can't feel anything from your waist down.
Whether a tear happens naturally or by an episiotomy, many OB/GYNs have found that it is not even possible to make a vagina tighter through stitching.
Squeeze the cheeks of your bottom together when you sit to avoid pulling painfully on the stitches. Sitting on a pillow may be more comfortable than sitting on a hard surface. Use a squirt bottle with warm water to wash the area with water when you use the toilet; gently pat dry.
If you had a straightforward birth, you can start gentle exercise as soon as you feel up to it. This could include walking, gentle stretches, pelvic floor and tummy exercises. It's usually a good idea to wait until after your 6-week postnatal check before you start any high-impact exercise, such as aerobics or running.
Avoid tampons for the first 6 weeks after giving birth. Buy a shallow mini-tub called a sitz bath that fits over the toilet seat and allows you to soak the stitches for cleansing and pain relief. Just remember that warm water soaks are not to be started until at least 24 hours after giving birth.
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.
It's unusual for pain after an episiotomy to last longer than 2 to 3 weeks. If the pain lasts longer than this, speak to a doctor, health visitor, or another health professional.
natural tearing. Research has shown that moms seem to do better without an episiotomy, with less risk of infection, blood loss (though there is still risk of blood loss and infection with natural tears), perineal pain and incontinence as well as faster healing.
Some possible complications of an episiotomy may include: Bleeding. Tearing into the rectal tissues and anal sphincter muscle which controls the passing of stool. Swelling.
It's common to feel some pain after an episiotomy. Painkillers such as paracetamol can help relieve pain and is safe to use if you're breastfeeding. It's also thought to be safe to take ibuprofen while you're breastfeeding, but check with your doctor first.
The healing process and the action of stitches dissolving can make the perineal skin itchy. While this type of itching is unpleasant, it will go away as the healing progresses with time.
Long-term effects of episiotomies can include: Chronic pain and infections. A small linear scar. Anorectal dysfunction.
The episiotomy tradition
Experts believed an incision would heal better than a natural tear. The procedure was also thought to help preserve the muscles and connective tissue that support the pelvic floor. Today, however, research suggests that routine episiotomies don't prevent these problems after all.
The amount of pain you have depends on how deep and long the incision is. You may have pain when you sit, walk, urinate, or have bowel movements. If you get enough fibre and fluids and use stool softeners or laxatives, you may have less pain during bowel movements.
The incision can be performed on either side and is generally 3-4 cm in length. The anatomic structures involved in a mediolateral episiotomy include the vaginal epithelium, transverse perineal muscle, bulbocavernosus muscle, and perineal skin.
Having an episiotomy can leave your perineum quite sore . The pain and discomfort can last for two or three weeks (NHS 2020, RCOG 2020). If it lasts for longer than that, or it gets worse, see your GP or your health visitor . It can help to take regular painkillers, so that you're comfortable.
With that said, the recovery time for a vaginal birth is significantly faster than a C-section. In most cases, mothers who delivered vaginally without an episiotomy felt better in 3 weeks or less; those with an episiotomy took the full 6 weeks.
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.
Keep the area around the stitches clean and dry. Pat the area dry with a clean towel after you bathe. After you urinate or have a bowel movement, spray warm water over the area and pat dry with a clean towel or baby wipe. Do not use toilet paper.
Stitches. If you've had stitches after tearing or an episiotomy (cut), bathe them every day to help prevent infection. Have a bath or shower with plain warm water then carefully pat yourself dry.
The two main types of episiotomy are the median and mediolateral, although seven different incisions have been described in the literature. Episiotomy is classified into the following types: Midline, Mediolateral, Lateral, the modified-median, J-shaped, anterior, and radical (Schuchardt incision).