Episiotomy: What to Expect at Home

Your Recovery

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 or midwife deliver the baby.

After your baby is born, the doctor or midwife 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.

Pain or discomfort should improve as you heal over the next few weeks. Most episiotomies heal in about 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?

Taking care of your body

• Use pads instead of tampons for bleeding. After birth, you will have bloody vaginal discharge. You may also pass some blood clots that shouldn't be bigger than an egg. Over the next 6 weeks or so, your bleeding should decrease a little every day and slowly change to a pinkish and then whitish discharge.
• For mild pain, try an over-the-counter pain medicine, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). Read and follow all instructions on the label.
• If your doctor or midwife gave you a prescription medicine for pain, take it as prescribed.
• Ease constipation by drinking plenty of fluids and eating high-fiber foods. Ask your doctor or midwife about over-the-counter stool softeners.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Avoid lifting anything heavy or doing strenuous activities, such as bicycle riding, jogging, and weightlifting, until your doctor or midwife says it is okay.
• When you feel ready, try to get some exercise every day. For many people, walking is a good choice.
• You may shower and take baths as usual. Pat the incision dry when you are done.
• Ask your doctor or midwife when it is okay for you to have sex.

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) when you can 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 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 passed out (lost consciousness).
• You have severe vaginal bleeding. You have soaked through one or more pads in an hour, and the bleeding is not slowing down.

Contact your doctor or midwife 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 wound.
  • Pus draining from the wound.
  • A fever.
  • Vaginal discharge that smells bad.
  • New or worse belly pain.

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

• Your vaginal bleeding isn't decreasing.