Care after an episiotomy

Wash your hands before and after changing a maternity pad or touching the area. Rinse or bathe the perineum with plain warm water, then pat gently from front to back rather than rubbing. Change pads regularly, and avoid perfumed washes, powders, or creams on the wound unless a clinician recommends them.

Soreness, bruising, swelling, and stinging when urine touches the wound can occur early in recovery. Dissolvable stitches support the cut while tissue joins and usually do not need routine removal. Small pieces of suture material may become visible as the stitches dissolve, provided the wound edges remain together.

Comfort should gradually improve. A sudden increase in pain, new unpleasant odour, pus-like discharge, spreading redness, or an opening between the wound edges is not expected healing and needs assessment. Ongoing pain with sex or difficulty controlling urine, wind, or stool also deserves follow-up.

A wrapped cold pack placed against the perineum for short periods can ease swelling; never place ice directly on skin. Use pain relief recommended for you by your maternity team or pharmacist, particularly if breastfeeding or taking other medicines. Sitting slightly to one side or lying down may reduce pressure.

Drink enough fluid and eat fibre-containing foods to keep stools soft. Avoid delaying a bowel movement. Supporting the wound gently with a clean pad while passing stool can feel reassuring, and pouring warm water over the vulva while urinating may reduce stinging. Begin pelvic-floor exercises when comfortable and according to your postnatal advice.

Contact your midwife, maternity unit, or doctor promptly if the stitches become more painful, the skin grows red or swollen, discharge smells unpleasant, pus appears, the wound opens, or you develop fever or feel unwell. Difficulty passing urine, severe constipation, or pain that is not controlled by the advised medicine also needs clinical advice.

Seek urgent help for very heavy vaginal bleeding, fainting, breathing difficulty, chest pain, or sudden severe illness after birth. These are postnatal warning signs regardless of how the episiotomy wound looks and should not wait for a routine check.

Ask whether the wound edges and stitches are healing as expected, which pain relief suits feeding and other medicines, and when to resume exercise, driving, and sex. Mention bowel or bladder leakage, pelvic heaviness, persistent tenderness, or fear about intimacy so the team can consider wound review or pelvic-health physiotherapy.