The most commonly reported complications of an episiotomy are:
- post-operative pain
- pain during sex
These complications are discussed in more detail below.
Post-operative pain
It is common for women to feel mild to moderate pain after having an episiotomy. However, research suggests that around 1 in a 100 women will feel severe pain that seriously affects their day-to-day activities and quality of life.
In such circumstances, it may be necessary to treat the pain with stronger prescription-only painkillers, such as codeine. If you are prescribed prescription-only medication, it may affect your ability to breastfeed safely. Your GP or midwife will be able to advise you further about this.
It is unusual for post-operative pain to persist for longer than two to three weeks.
Pain during sex
Pain during sex is very common in the first few months after an episiotomy. Studies have found that around 9 out of 10 women who had an episiotomy reported that resuming sex after the procedure was very painful, but that the pain improves over time.
Many women have reported that the pain is often related to persistent vaginal dryness, so using artificial lubrication, such as lubricating gels, may help.
Water-based lubricants are recommended rather than petroleum based lubricants, such as petroleum jelly (Vaseline) because these types of lubricants can damage the vagina and make barrier forms of contraception, such as condoms or diaphragms, less effective.
You may find that using methods of sexual interaction other than penetrative sex, such as mutual masturbation, is more satisfying in the initial months after childbirth.
Scar tissue
In a few women, excessive, raised or itchy scar tissue forms around the place where a tear happened or where an episiotomy was performed. A small operation called a Fenton's procedure can be done to remove the scar tissue. This is done at least six months after childbirth, when the tissues have healed from the stretching, bruising and tearing of childbirth.
The operation involves neatly cutting out the scar tissue and sewing together the clean-cut edges with small stitches.
As with all wounds, there is a small risk of infection, so keep your stitches clean at all times.
