What should you know about giving birth after episiotomy?

An episiotomy is an incision in the perineum, the tissue between the vaginal opening and anus, made during some births and closed with dissolvable stitches. Soreness, bruising, swelling and a pulling sensation can make sitting, walking or passing urine uncomfortable at first. Healing can also affect bowel movements, sexual comfort and confidence. Improvement should be gradual, but the wound may need assessment if pain increases instead of easing or if the edges separate.

Keep the area clean with plain water as advised, pat it dry, change pads regularly and wash your hands before and after toileting. Take prescribed or recommended pain relief, rest between activities, and use the bowel-care plan from your maternity team to avoid straining. Gentle pelvic-floor exercises can be introduced when comfortable. Do not resume penetrative sex until bleeding has settled, the wound has healed and you feel ready. Persistent scar pain, painful sex or leakage deserves review; [Perineal Repair](/treatments/pregnancy-and-birth-care/perineal-repair/) may be discussed when further treatment is needed.

Contact your maternity team promptly for worsening pain, increasing redness or swelling, pus-like discharge, a bad smell, fever, heavy bleeding, wound opening, difficulty passing urine or loss of bowel control. Seek urgent help for heavy bleeding with dizziness, fainting, severe weakness or trouble breathing. These signs can indicate infection, significant bleeding or another postpartum problem.

Ask how the stitches are healing, which pain medicines are suitable while breastfeeding, when to begin pelvic-floor exercises, how to manage constipation, and when to return for a wound review. Mention pain with sex, numbness, leakage or fear of another birth so the plan can address the specific problem.