Third-degree tear and episiotomy after birth

An episiotomy is a deliberate cut made to widen the vaginal opening; it is different from a tear, although a tear can extend from the episiotomy. The maternity team should explain the injury and repair before discharge.

The perineum lies between the vaginal opening and anus. In a third-degree tear, the injury reaches part or all of the muscles that help control wind and stool, but does not extend through the lining inside the anus. Clinicians may use a more detailed grade to describe how much muscle is involved.

Repair is usually performed soon after birth with anaesthesia and dissolvable stitches. Swelling, bruising and soreness are expected early on, while increasing pain, wound separation or loss of bowel control warrants review.

Take prescribed pain relief and antibiotics as directed. A stool softener or laxative may be advised to reduce straining; drink fluids, eat fibre-rich foods and respond to the urge to open your bowels. Wash gently with water, change maternity pads regularly and pat the area dry.

Begin pelvic-floor exercises when the maternity team says they are suitable, and attend any specialist physiotherapy or postnatal appointment offered. Increase walking and lifting gradually. Resume sex only when the wound has healed and you feel ready; lubricant may make early discomfort easier.

Arrange prompt maternity assessment if pain or swelling is getting worse, the wound opens, discharge smells unpleasant, you develop fever, or you cannot control wind or stool. Difficulty passing urine, constipation despite the recommended treatment, or persistent urgency also deserves specific advice.

Seek urgent care for heavy vaginal bleeding accompanied by weakness or faintness, severe illness, chest pain, breathlessness, or a painful swollen leg. These are postnatal warning signs regardless of the tear itself.

Ask which muscles were involved, whether healing is complete, and how to access pelvic-health physiotherapy. Mention bowel leakage, urgency, pain during sex or fear about using your bowels directly. Before another pregnancy, discuss how this injury and your current symptoms may influence plans for birth.