Episiotomy

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KEY POINTS

• An episiotomy is a cut in the tissue between the opening of the vagina and the rectum to widen the opening of your vagina for childbirth.
• This procedure may be done if your baby’s head is large or the shoulders get stuck during birth.
• Ask your provider how long it will take to recover and how to take care of yourself at home. Make sure you know what symptoms or problems you should watch for and what to do if you have them.

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What is an episiotomy?

An episiotomy is a 1- to 3-inch (2 to 4 cm) cut made in the tissue between the opening of the vagina and the rectum. It widens the opening of your vagina for childbirth.

When is it used?

Your healthcare provider may recommend an episiotomy when your baby is being born. It might help delivery, for example, if your baby’s head is large or the shoulders get stuck during birth.

What happens during the procedure?

When the baby's head is stretching the opening of your vagina, your healthcare provider will first numb the area with an anesthetic unless you have already been given an epidural block for pain. An epidural block is given through your lower back to numb the birth canal and the area around the baby during labor and delivery.

Your provider will then make a cut from the opening of the vagina toward the rectum.

After you deliver your baby, your healthcare provider will stitch the cut closed. The stitches will dissolve in about 10 days.

What happens after the procedure?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

You can relieve pain and swelling by:

• Putting an ice pack, gel pack, or package of frozen vegetables, wrapped in a cloth on the area
• Taking warm tub baths 2 or 3 times a day for 20 minutes. Wait at until at least 24 hours after your baby was born before you start taking baths.
• Using sprays or pads that contain a numbing medicine
• Taking nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age. Take them with food whenever possible.
  • Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don't take more than 3000 milligrams (mg) in 24 hours. To make sure you don’t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.

It is best to wait 4 to 6 weeks until the cut has fully healed and your healthcare provider says it’s OK to have sex again. Having sex too soon after the birth can cause pain. Ask your provider:

• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

What are the risks of this procedure?

Every procedure or treatment has risks. Some possible risks of this procedure include:

• More blood loss
• Poor healing or infection of the cut
• Pain after delivery
• Pain when you have sex
• Discomfort in the scar
• Hematoma (blood collection) in the vagina

Ask your healthcare provider how the risks apply to you. Be sure to discuss any other questions or concerns that you may have.