An episiotomy can speed delivery. But is the procedure necessary?
An episiotomy is an incision made in the tissue between the vaginal opening and anus (perineum) during childbirth. Although an episiotomy was once a routine part of childbirth, that's no longer the case. If you're planning a vaginal delivery, here's what you need to know about episiotomy and childbirth.
The new approach
Researchers say there's no need for a routine episiotomy, but the procedure is still warranted in some cases. Your health care provider may recommend an episiotomy if:
- Extensive vaginal tearing appears likely
- Your baby is in an abnormal position
- Your baby needs to be delivered quickly
If you need an episiotomy, you'll receive an injection of a local anesthetic to numb the tissue if you haven't had any other type of anesthesia or your anesthesia is no longer numbing the area. You won't feel your health care provider making the incision or repairing it after delivery.
Healing from an episiotomy
If you have an episiotomy or tear during delivery, the wound may hurt for a week or two — especially when you walk or sit. If the incision or tear is extensive, the tenderness may last longer. Any stitches used to repair the episiotomy will usually be absorbed on their own. In the meantime, you can help promote healing:
- Soothe the wound. Use an ice pack, or wrap ice in a washcloth. Chilled witch hazel pads may help, too. Witch hazel is the main ingredient in many hemorrhoid pads. You can find witch hazel pads in most pharmacies.
- Keep the wound clean. Use a squirt bottle to rinse the tissue between the vaginal opening and anus with water after using the toilet. Soak in a warm tub.
- Take the sting out of urination. Squat rather than sit to use the toilet. Pour warm water over your vulva as you're urinating.
- Prevent pain and stretching during bowel movements. Hold a clean pad firmly against the wound and press upward while you bear down. This will help relieve pressure on the wound.
- Sit down carefully. To keep your bottom from stretching, squeeze your buttocks together as you sit down. If sitting is uncomfortable, use a doughnut-shaped cushion to ease the pressure.
- Do your Kegels. These exercises help tone your pelvic floor muscles. Simply tighten your pelvic muscles as if you're stopping your stream of urine. Starting about a day after delivery, try it for five seconds at a time, four or five times in a row. Work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions. Aim for at least three sets of 10 repetitions a day. You can do Kegels while standing, sitting or lying down — even while breast-feeding your baby.
- Use medication as needed. Your health care provider may order prescription medications or recommend an over-the-counter pain reliever or stool softener.
- Look for signs of infection. If the pain intensifies or the wound becomes hot, swollen and painful or produces a pus-like discharge, contact your health care provider.
Last Updated: 06/20/2008
