Types of episiotomy

A midline episiotomy travels straight from the vaginal opening towards the anus. A mediolateral episiotomy starts at the opening and angles away from the anus, usually to one side. Some services use a lateral approach, which begins to the side and stays farther from the anal sphincter. The exact wording in your notes may vary by maternity unit.

The incision may remain limited to the perineal skin and muscle, or it may extend during birth. Your clinician can tell you which direction was used, whether the cut extended, and which structures were repaired. Soreness and swelling are common early concerns, but severe or worsening symptoms need assessment.

Keep a copy of the discharge instructions and ask for the incision direction if it was not explained. Clean gently, pat dry, change pads regularly and prevent constipation with fluids, fibre and any recommended stool-softening treatment. Use prescribed or approved pain relief and pace sitting, walking and lifting according to comfort.

The type of incision does not replace an individual examination. Tell your clinician about persistent pain, pulling at the scar, urinary difficulty, bowel changes or pain with sex. Perineal Repair explains the repair pathway and aftercare.

Contact your maternity team for fever, increasing redness or swelling, unpleasant-smelling discharge, wound opening or pain that is getting worse. Urgent assessment is needed for heavy bleeding, faintness, severe pain, inability to pass urine, or new difficulty controlling stool or wind.

Ask which type was used, whether it extended, what muscles were involved, how the stitches are healing, when follow-up should occur, and what activities should wait until recovery progresses.