What should you know about emergency episiotomy?

The perineum is the tissue between the vaginal opening and anus. During an urgent situation, the birth team may recommend an episiotomy when there is concern about the baby's wellbeing, assisted vaginal birth, or a need to make space for delivery. The clinician explains the reason when circumstances allow, uses local anaesthetic unless an effective epidural is already present, and closes the cut with dissolvable stitches.

An episiotomy is not the same as a natural tear, although both can need stitching and similar aftercare. The cut can be sore when sitting, walking, urinating, or opening the bowels while healing.

Keep the area clean and dry, change maternity pads regularly, and wash your hands before and after toilet care. Use the pain relief recommended by your maternity team, rest when possible, and support the area when opening your bowels. Gentle pelvic-floor exercises may be introduced when comfortable. Ask for an examination if pain is making movement, feeding, sleep, or toileting difficult.

Contact your maternity service promptly for increasing pain, wound opening, worsening swelling, pus, foul-smelling discharge, fever, or feeling unwell. Seek urgent help for heavy bleeding, faintness, or sudden severe pain. Ongoing problems with bladder control, bowel control, or sexual pain deserve a postnatal assessment rather than being dismissed as part of recovery.

Ask what prompted the episiotomy, how the wound is healing, which pain medicines are suitable if breastfeeding, how to protect the stitches during bowel movements, and when to arrange a pelvic-floor or perineal review.