After an episiotomy: caring for the wound

Tenderness, swelling and stinging when urine touches the area can occur early in healing. Discomfort should trend toward improvement. Your maternity team can examine the stitches if pain intensifies or you are uncertain about the wound.

An episiotomy is a cut through the perineum made during vaginal birth and repaired with stitches. The area moves during sitting, walking and bowel movements, which can make recovery uncomfortable. Dissolvable stitches usually soften and disappear as healing progresses rather than needing routine removal.

Post-birth vaginal bleeding is separate from bleeding at the wound. A clinician or midwife can distinguish normal healing from infection, a collection of blood under the tissue, or edges that have opened.

Wash your hands before and after changing a maternity pad, change pads regularly and gently rinse the perineum with water. Pat dry instead of rubbing. Use only pain medicines considered suitable for you, especially if breastfeeding or taking other medication.

Drink fluids, eat fibre and follow advice about stool softeners so you do not need to strain. Rest in positions that reduce pressure, then build walking and usual activity gradually. Pelvic-floor exercises may support recovery when they are comfortable. Resume sex when bleeding and the wound have settled and you feel physically and emotionally ready; lubricant may help with dryness.

Contact your maternity team promptly if pain or swelling is worsening, the area becomes increasingly red or hot, pus or an unpleasant smell appears, stitches seem to separate, or you develop fever or chills. Seek urgent help for heavy bleeding, fainting, breathing difficulty, confusion or feeling severely unwell.

Also request assessment for difficulty controlling wind or stool, inability to pass urine, persistent painful sex after healing, or pain that interferes with caring for yourself or your baby. These problems can be assessed and treated rather than endured.

Ask whether the wound is healing as expected, which pain relief and bowel-care options suit you, and when to begin pelvic-floor rehabilitation. Mention urinary leakage, bowel-control changes, scar tenderness or fear of sex so the clinician can offer an examination, physiotherapy or other focused care.