What should you know about gaped episiotomy?

An episiotomy is a cut made in the perineum during birth and closed with stitches. The wound can separate as it heals. You may notice an opening, increased soreness, bleeding, discharge, a pulling sensation, or difficulty sitting. A clinician needs to determine whether the edges are slightly apart or whether deeper tissue is involved.

The examination may include checking the wound, temperature, pain, bleeding, and bowel or bladder symptoms. Infection, pressure on the wound, or delayed healing can affect the plan. Some wounds heal with careful wound care, while others need antibiotics, removal of infected material, or delayed perineal repair once infection has settled.

Contact your maternity team, midwife, or doctor promptly for an assessment. Keep the area clean with plain water, pat it dry, change maternity pads regularly, and wash your hands before and after care. Rest when possible and avoid sex, tampons, swimming, and strenuous activity until a clinician says the wound is ready.

Do not pull at stitches, apply antiseptic or perfumed products, or attempt to close the opening yourself. Use only pain relief that is suitable for you, especially if breastfeeding or taking other medicines. Tell the clinician about fever, new discharge, worsening pain, or problems passing urine or stool.

Seek urgent help for heavy bleeding, severe or rapidly increasing pain, fever, feeling faint, confusion, pus or a strong unpleasant smell, spreading redness, or inability to pass urine. Emergency assessment is also needed if the wound opens suddenly after a fall or strain, or if you feel seriously unwell.

Ask: How deep is the separation? Is there infection? Do I need a swab, antibiotics, or a repair? How should I clean the area, manage bowel movements, control pain, and know when sex or exercise is safe?