Episiotomy incisions are usually repaired within an hour of the baby's birth. The incision may bleed quite a lot initially, but with pressure and stitches this should soon stop
Usually, dissolving stitches are used, so you won't need to go back to hospital to have them removed. Stitches should heal one month after the birth. Talk to your midwife or obstetrician about which activities you should avoid during the healing period.
After having an episiotomy, it is normal to feel pain at the site of the cut for one or two weeks after giving birth, particularly when walking or sitting. Stretching and passing urine can also cause the cut to sting.
Healing and pain relief
The following advice will help to provide pain relief and promote healing after having an episiotomy.
Painkillers
Painkillers, such as paracetamol and ibuprofen, can help to relieve pain and are safe to use if you are breastfeeding. Aspirin is not recommended because it can be passed on to your baby via your breast milk.
Using a donut-shaped cushion or squeezing your buttocks together while you are sitting may also help to relieve the pressure and pain at the site of your cut.
Ice
Placing an ice pack or ice cubes wrapped in a towel on the incision can often help to relieve pain. Avoid placing ice directly on to your skin because this could damage it.
Exposing the stitches that were used to seal the incision to fresh air can encourage the healing process. Taking off your underwear and lying on a towel on your bed for around 10 minutes once or twice a day may help.
Toilet hygiene
Keep the incision and the surrounding area clean to prevent infection. After going to the toilet, use a bottle that you can squirt liquid from, such as an empty shampoo bottle, to rinse the area between your vagina and anus.
When wiping your bottom, make sure that you wipe from front to back because this will help to prevent bacteria in your anus infecting the cut and surrounding tissue.
You may find that squatting over the toilet, rather than sitting on it, reduces the stinging sensation when passing urine. Pouring warm water over the outer area of your vagina may also help.
When you are passing a stool, you may find it useful to place a clean pad at the site of the cut and press up as you are straining down. This can help to relieve pressure on the cut.
If you find passing stools particularly painful, you may benefit from talking a short-course of bulk-forming laxatives. This type of medication is usually used to treat constipation and makes stools softer and easier to pass. See constipation - treatment for more information.
Infection
Look out for any signs that the cut or surrounding tissue has become infected, such as red, swollen skin or a discharge of pus or liquid from the site of the cut. Report any possible signs of infection to your GP or midwife as soon as possible.
Exercises
Strengthening the muscles around the affected area by doing pelvic floor exercises can help to promote healing and will reduce the pressure on the incision and surrounding tissue.
Pelvic floor exercises involve squeezing the muscles around your vagina and anus. Your midwife can show you how to perform the exercises correctly. A downloadable NHS information sheet is available called Pelvic floor exercises for women (pdf - 68KB).
