What an extended episiotomy involves

An episiotomy is an incision in the tissue between the vaginal opening and anus to help deliver the baby. During birth, the incision can extend into nearby perineal muscle or, in a deeper injury, toward the anal sphincter or rectal tissue. The clinician examines the area to identify the structures involved and grades the injury.

Repair is usually performed with local or regional anaesthesia, using stitches that dissolve as the wound heals. The repair may involve several tissue layers. Your discharge information should state the injury's depth and explain wound care, pain relief, bowel care and follow-up.

Keep the area clean and dry, change sanitary pads regularly, wash your hands before and after pad changes, and take prescribed pain relief. Rest when possible, avoid constipation by following the recommended fluid and fibre plan, and use any stool-softening medicine as directed. Pelvic-floor exercises can be introduced when your clinician says they are suitable.

Attend the planned review, especially if the tear involved the anal sphincter. Ask before resuming penetrative sex, strenuous activity or driving; comfort, bleeding and wound healing all matter.

Contact your maternity team promptly for worsening pain, increasing redness or swelling, pus or a bad smell, fever, wound separation, difficulty controlling urine or stool, or new loss of bowel control. Heavy bleeding, fainting, severe weakness or breathing difficulty requires emergency care.

Ask how far the incision extended, which muscles were repaired, how to protect bowel movements, when the wound will be reviewed, what symptoms suggest infection or separation, and when sex, exercise and another pregnancy can be considered safely.