Episiotomy: What to Expect at Home
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 fibre 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.
This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.
How can you care for yourself at home?
- 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 or midwife 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 or midwife says it is okay.
- Ask your doctor or midwife when it is okay for you to have sex.
- 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 or midwife may suggest fibre, a stool softener, or a mild laxative.
- 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 take aspirin or some other blood thinner, ask your doctor if and when to start taking it again. Make sure that you understand exactly what your doctor wants you to do.
- 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.
- 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 centimetres 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.
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 advice line (811 in most provinces and territories) 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.
When should you call for help?
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 have thoughts of harming yourself, your baby, or another person.
- You passed out (lost consciousness).
- You have chest pain, are short of breath, or cough up blood.
- You have a seizure.
Call your doctor, midwife, or nurse advice line 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 light-headed, 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 pre-eclampsia, 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, midwife, or nurse advice line 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.
Where can you learn more?
Go to https://www.healthwise.net/patientEd
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Current as of: February 23, 2022
Author: Healthwise Staff
Medical Review:Adam Husney MD - Family Medicine & Kathleen Romito MD - Family Medicine & Kirtly Jones MD - Obstetrics and Gynecology