What should you know about degrees of episiotomy?

An episiotomy is a surgical cut in the perineum, the area between the vaginal opening and anus, made during some births. First-degree injuries involve skin. Second-degree injuries extend into perineal muscle. Third-degree injuries involve the anal sphincter muscle, while fourth-degree injuries extend through the anal lining. The degree is recorded after examination and helps determine the repair and follow-up required.

Soreness, swelling, bruising, and discomfort when sitting or passing urine can occur during early healing. Bowel movements may feel difficult, and scar tenderness can affect movement or sex for a time. Recovery differs between people, especially when deeper tissues are involved.

Follow the wound-care instructions you were given, keep the area clean, and use prescribed or recommended pain relief. Rest between activities, drink fluids, and follow advice about preventing constipation so the repair is not strained. Pelvic-floor relaxation and strengthening may be introduced at the appropriate stage. Perineal repair follow-up is especially useful when the cut was deep or symptoms persist.

Contact your maternity or medical team promptly for increasing pain, spreading redness, fever, pus-like discharge, wound separation, heavy bleeding, or difficulty controlling gas or stool. Seek urgent care if you feel very unwell, have severe pain, or experience sudden heavy bleeding.

Ask which degree was recorded, how the repair is healing, what bowel-care and activity advice applies, when pelvic-floor exercises can begin, and which changes should trigger a review.