If you have any concerns in any future pregnancies, discuss these with your healthcare professional, so that you can make a birth plan that you are comfortable with. We would like to understand how people are using this resource to help ensure it is relevant and useful.
To give us your feedback, please complete our short survey. If you have any questions, please email womensvoices rcog. Toggle navigation. Home Patients Perineal tears and episiotomies in childbirth Perineal wound breakdown. Toggle navigation Other pages in this section. Perineal tears and episiotomies in childbirth Perineal tears during childbirth Reducing your risk of perineal tears First- and second-degree tears Third- and fourth-degree tears OASI Episiotomy Your pelvic floor Perineal wound breakdown.
Perineal wound breakdown Overview of perineal wound breakdown and what to expect. Dissolvable stitches are used, so you will not need to return to hospital to have them removed. An episiotomy may be recommended if your baby develops a condition known as foetal distress, where the baby's heart rate gets faster or slower before birth. This means your baby may not be getting enough oxygen and has to be delivered quickly to avoid the risk of birth injuries or stillbirth.
Another reason for an episiotomy is because it's necessary to widen your vagina so instruments, such as forceps or ventouse suction, can be used to help with the birth. Research shows that in some births, particularly with forceps deliveries, an episiotomy may prevent tears that affect the anal muscle third-degree tears.
An episiotomy is usually a simple procedure. A local anaesthetic is used to numb the area around the vagina so you do not feel any pain.
If you have already had an epidural, the dose can be topped up before the cut is made. Whenever possible, the doctor or midwife will make a small diagonal cut from the back of the vagina, directed down and out to one side. The cut is stitched together using dissolvable stitches after the birth. Episiotomy cuts are usually repaired within an hour of your baby's birth.
The cut may bleed quite a lot at first, but this should stop with pressure and stitches. Stitches should heal within 1 month of the birth. Talk to your midwife or obstetrician about which activities you should avoid during the healing period.
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.
Aspirin is not recommended as it can be passed on to your baby through your breast milk. Your midwife will advise you if you're not sure what painkillers to take. It may be necessary to treat severe pain with stronger prescription-only painkillers, such as codeine. However, prescription-only medicine may affect your ability to breastfeed safely. Your GP or midwife can advise you about this.
Exposing the stitches to fresh air can help the healing process. Taking off your underwear and lying on a towel on your bed for around 10 minutes once or twice a day may help. 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.
Keep the cut and the surrounding area clean to prevent infection. After going to the toilet, pour warm water over your vaginal area to rinse it. A perineal tear can happen when you deliver your baby. It is a tear to your perineum say "pair-uh-NEE-um" , which is the area between your vagina and anus. After delivery, the doctor or midwife usually closes the perineal tear with stitches.
The stitches will dissolve in 1 to 2 weeks, so they will not need to be removed. You may notice pieces of the stitches on your sanitary pad or on the toilet paper when you go to the washroom. This is normal. Sometimes, a small tear won't be closed with stitches and will be allowed to heal on its own. You may place an ice pack against your perineum to ease pain and swelling.
Recovery can be uncomfortable or painful, depending on how deep and long the tear is. It's most painful at the beginning, but you should feel better each day. Pain typically affects sitting, walking, urinating, and bowel movements for at least a week. Your first bowel movement may be painful. A tear is usually healed in about 4 to 6 weeks.
This care sheet gives you a general idea about how long it will take for you to recover. But each woman recovers at a different pace. Follow the steps below to feel better as quickly as possible. Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take. Call anytime you think you may need emergency care.
For example, call if:. Call your doctor, midwife, or nurse call line now or seek immediate medical care if:. Watch closely for changes in your health, and be sure to contact your doctor, midwife, or nurse call line if:. Author: Healthwise Staff. Care instructions adapted under license by your healthcare professional.
If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. It looks like your browser does not have JavaScript enabled.
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