What is episiotomy?

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Episiotomy

An episiotomy is an incision made in the tissue between the vagina and anus (perineum) during childbirth, just before the baby's head is delivered. An episiotomy may be done to help deliver the baby.

After delivery, an episiotomy incision is stitched closed. Episiotomies can be different depths. Smaller episiotomies heal faster and with less pain.

How can you care for yourself after an episiotomy?

Activity

  • Rest when you feel tired.
  • Be active. Walking is a good choice.
  • Allow your body to heal. Don't move quickly or lift anything heavier than your baby until you are feeling better.
  • Ask your doctor when you can drive again.
  • You may shower and take baths as usual. Pat the incision dry when you are done.
  • You will have some vaginal bleeding. Wear sanitary pads. Do not douche or use tampons until your doctor says it is okay.
  • Ask your doctor when it is okay for you to have sex.

Diet

  • You can eat your normal diet.
  • Drink plenty of fluids (unless your doctor tells you not to).
  • If your bowel movements are not regular right after surgery, try to avoid constipation and straining. Drink plenty of water. Your doctor may suggest fiber, a stool softener, or a mild laxative.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Be safe with medicines. Read and follow all instructions on the label.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.

Incision care

  • Put ice or a cold pack on the sore area for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.
  • Sit in a few inches of warm water (sitz bath) 3 times a day and after bowel movements. The warm water helps with pain and itching. It may feel better to dry the area with a hair dryer instead of a towel.
  • After you use the toilet, pour or spray warm water over your vagina and anus. This will help keep the area clean.
  • After a bowel movement, it may feel better to wipe with baby wipes or medicated pads, such as Tucks.

What is an episiotomy?

An episiotomy (say "eh-pih-zee-AH-tuh-mee") is a cut, or incision, made in the perineum during childbirth. The perineum is the tissue between the vagina and anus. The cut may be done to help deliver the baby or to help prevent the muscles and skin from tearing.

The cut is made just before the baby's head comes out of the birth canal. The cut is stitched up after the birth.

After episiotomy: When to call

Share this information with your partner, family, or a friend. They can help you watch for warning signs.

Call 911 anytime you think you may need emergency care. For example, call if:

  • You feel you cannot stop from hurting yourself, your baby, or someone else.
  • You passed out (lost consciousness).
  • You have chest pain, are short of breath, or cough up blood.
  • You have a seizure.

Call your doctor now or seek immediate medical care if:

  • You have signs of hemorrhage (too much bleeding), such as:
    • Heavy vaginal bleeding. This means that you are soaking through one or more pads in an hour. Or you pass blood clots bigger than an egg.
    • Feeling dizzy or lightheaded, or you feel like you may faint.
    • Feeling so tired or weak that you cannot do your usual activities.
    • A fast or irregular heartbeat.
    • New or worse belly pain.
  • You have symptoms of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.
    • Vaginal discharge that smells bad.
    • New or worse belly pain.
  • You have symptoms of a blood clot in your leg (called a deep vein thrombosis), such as:
    • Pain in your calf, back of the knee, thigh, or groin.
    • Redness and swelling in your leg or groin.
  • You have signs of preeclampsia, such as:
    • Sudden swelling of your face, hands, or feet.
    • New vision problems (such as dimness, blurring, or seeing spots).
    • A severe headache.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • Your vaginal bleeding isn't decreasing.
  • You feel sad, anxious, or hopeless for more than a few days.
  • You are having problems with your breasts or breastfeeding.

After episiotomy: Overview

An episiotomy is a cut, or incision, in your perineum. Your perineum is the tissue between the vagina and anus.

The cut is made before the baby's head is delivered during childbirth. It can help the doctor deliver the baby.

After your baby is born, the doctor closes the incision with stitches. These stitches don't need to be removed. They will dissolve in 1 to 2 weeks or longer. You may notice pieces of the stitches on your sanitary pad or on toilet paper. This is normal.

Recovery can be uncomfortable. 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 fiber and fluids and use stool softeners or laxatives, you may have less pain during bowel movements. 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.

Why is an episiotomy done?

There are times when an episiotomy is needed. For example, it may be needed if the baby's heart rate drops too much during pushing. Or it may be done if the baby's position is causing problems. The decision can't be made until delivery.

Routine episiotomy is not recommended. Experts say that it's usually not needed during most births.

In the past, an episiotomy was a very common part of childbirth. Most doctors no longer do these cuts routinely. If you need an episiotomy, your doctor or midwife will tell you. It's a good idea to talk about an episiotomy during a regular prenatal visit.

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