Episiotomy Care

An episiotomy is an incision in the perineum to make extra room for a baby’s head during childbirth. The perineum is the area of tissue between the vagina and anus.

Medical experts no longer recommend routine episiotomies but in some instances, they can be required. 

Healing after an episiotomy is usually uncomplicated, but the healing process can take several weeks. The sutures (stitches) placed after an episiotomy usually dissolve within 6-8 weeks, so they do not need to be removed. It’s important to keep the area around your incision and stitches as clean and dry as possible to promote healing. Tampons, sexual intercourse, douching, and any other activities that might cause the sutures to break need to be avoided for at least 6 weeks after giving birth.

Episiotomy Common Problems

The most common problem experienced after having an episiotomy is pain. Treatments for incision pain include applying ice packs, warm baths, rest, and pain relievers, such as ibuprofen. Experts recommend using ice therapy in the first 24 hours after giving birth (15-20 minutes for 3-4 times per day). Latex gloves filled with ice cubes can work really well for this purpose. After the first 24 hours, it’s recommended to transition to therapies that use heat and warmth, such as baths, for both pain control and to promote wound healing.

Self Care After An Episiotomy

Self-care after an episiotomy includes the following:

  • Hydration. Drinking plenty of water is key.
  • Sitz baths. Taking a warm shallow bath using a water basin for up to 15 minutes, 2-3 times per day. Adding Epsom salts to baths can also help. Baths can begin 24 hours after delivery.
  • Cleaning. Be sure to rinse then keep the area clean and dry by changing pads often (every 2-4 hours).  Spray and rinse the perineal area with warm water using a “peri-bottle” each time that you urinate or have a bowel movement. Be sure to gently pat your incision dry with a clean towel when finished. Soap is not needed (especially soaps with perfume additives) and can actually be irritating.
  • Stool softeners. Keeping your stool soft is essential to prevent constipation and straining.
  • Cushions. Sitting on a donut-shaped cushion, or rolled towels underneath your thighs, helps to take pressure off areas with stitches or swelling. When not sitting, resting on your sides can help to take direct pressure off the perineum.
  • Pain relievers. Especially topical numbing sprays, such as benzocaine, can make all the difference. 

Episiotomy Symptoms

Worrisome symptoms while healing from an episiotomy include the development of fever or chills, severe perineal pain, bleeding from the incision site, and/or foul-smelling vaginal discharge. These can be signs of an infection and need to be discussed with your obstetrician as soon as possible.

You may eat a normal diet after having an episiotomy and may resume physical activity as tolerated. Walking is an excellent way for postpartum moms to be active without overdoing it. Lastly, it’s very important to go to all scheduled visits with your obstetrician and to call your doctor before your follow-up visit if you have any questions or concerns.

About the Author

Jessica Madden, MD, is the Medical Director at Aeroflow BreastpumpsDr. Madden has been a board-certified pediatrician and neonatologist for over 15 years. She's currently on staff in the neonatal intensive care unit (NICU) at Rainbow Babies and Children’s Hospital in Cleveland, OH. She previously worked in the Boston and Cleveland Clinic Children’s Hospitals. In 2018 she started Primrose Newborn Care to provide in-home newborn medicine and lactation support. She also enjoys traveling, yoga, reading, and spending time with her children.

Information provided in blogs should not be used as a substitute for medical care or consultation.