Mediolateral episiotomy

The perineum is the area between the vaginal opening and anus. In a mediolateral cut, the incision starts at the vaginal opening and angles to one side. It may be considered if the baby needs to be born quickly, instruments are being used, or there is concern about a significant tear. The decision should be explained where circumstances allow.

Local anaesthetic is used unless an epidural or another form of pain relief is already working. After birth, the cut is closed with dissolvable stitches. Healing can involve soreness, swelling, bruising, tightness, and discomfort when sitting, walking, passing urine, or having sex. Recovery varies, and symptoms should gradually settle rather than worsen.

Keep the area clean with water, pat dry, change pads regularly, and wash your hands before and after care. Rest when possible, use the pain relief advised for you, and avoid straining when opening your bowels. Fluids, fibre, and a gentle return to movement can help. A cold pack wrapped in cloth may reduce early swelling.

Attend the recommended postnatal review. If pain, scar tightness, or pain with sex persists, ask about pelvic floor physiotherapy or perineal repair assessment. Do not insert anything into the vagina until your maternity clinician says healing is adequate.

Contact your maternity team promptly for increasing pain, spreading redness, warmth, pus or bad-smelling discharge, fever, wound separation, difficulty passing urine, or bleeding that becomes heavy. A sudden change after initial improvement deserves review because infection or a wound problem may need treatment.

Why was the cut needed? Which pain relief can I use? How should I care for the stitches? When can I resume sex and exercise? What symptoms mean the wound needs checking? Would perineal repair or pelvic floor therapy help?