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Episiotomy - aftercare

Perineal laceration - aftercare; Vaginal birth perineal tear - aftercare; Postpartum care - episiotomy - aftercare

Description

An episiotomy is a minor incision made during childbirth to widen the opening of the vagina.

A perineal tear or laceration often forms on its own during a vaginal birth. Rarely, this tear will also involve the muscle around the anus or the rectum. (The last two problems are not discussed here.)

Both episiotomies and perineal lacerations require stitches to repair and ensure the best healing. Both are similar in recovery time and discomfort during healing.

What to expect

Most women heal without problems, although it may take many weeks.

Your stitches do not need to be removed. Your body will absorb them. You can return to normal activities when you feel ready, such as light office work or house cleaning. Wait 6 weeks before you:

  • Use tampons
  • Have sex
  • Do any other activity that might rupture (break) the stitches

Self-care

To relieve pain or discomfort:

  • Ask your nurse to apply ice packs right after the birth. Using ice packs in the first 24 hours after birth decreases the swelling and helps with pain.
  • Take warm baths, but wait until 24 hours after you have given birth. Make sure that the bathtub is cleaned with a disinfectant before every bath.
  • Take medication like ibuprofen to relieve pain.

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. If you prefer, you can sit in this kind of tub instead of climbing into the bathtub.
  • Change your pads every 2 to 4 hours.
  • 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.

Take stool softeners and drink lots of water. This will prevent constipation. Eating lots of fiber will also help. Your doctor can suggest foods with plenty of fiber.

Do Kegel exercises. Squeeze the muscles that you use to hold in urine for 5 minutes. Do this 10 times a day throughout the day.

When to call the doctor

  • Your pain gets worse
  • You go for 4 or more days without a bowel movement
  • You pass a blood clot larger than a walnut
  • You have a discharge with a bad odor
  • The wound seems to break open

References

Mohamed HAEA, El-Nagger NS. Effect of self perineal care instructions on episiotomy pain and wound healing of postpartum women. J Am Sci. 2012;8(6);640-650.

Rosenthal MT. Episiotomy and repair of the perineum. In: Pfenninger JL, Fowler GC. Procedures for Primary Care. 3rd ed. 2010:chap 166.

Update Date: 6/11/2014

Updated by: Cynthia D. White, MD, Fellow American College of Obstetricians and Gynecologists, Group Health Cooperative, Bellevue, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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