What should you know about midline episiotomy?

The cut is made through perineal tissue during labour, usually after local anaesthetic or another form of pain relief has taken effect. A clinician may discuss it when birth needs to happen quickly, instruments are being used, or the perineum needs more space. A midline cut points toward the anal muscles, so the birth team weighs its position against the possibility of a deeper tear. The incision is closed with stitches after birth. The repair is intended to restore the layers of tissue, but soreness, swelling, bruising, and tightness can occur while healing.

Keep the area clean and dry as advised, change maternity pads regularly, and wash your hands before and after care. Rest, use prescribed or recommended pain relief, and follow instructions about pelvic-floor exercises. Passing urine can sting; drinking fluids and using a gentle rinse may help if your maternity team recommends it. Avoid inserting anything into the vagina until your clinician says healing allows it. A follow-up can assess wound healing, pain, bowel symptoms, and comfort with sex.

Contact your maternity team promptly for worsening pain, increasing redness or swelling, pus or unpleasant-smelling discharge, fever, heavy bleeding, wound opening, difficulty controlling urine or stool, or new trouble passing stool. Sudden severe pain or feeling very unwell needs urgent care. Do not wait for a routine appointment if symptoms are rapidly worsening.

Why was a midline incision recommended in my birth? How should I care for the stitches? When can I resume exercise, intercourse, and pelvic-floor work? Which changes suggest infection or a deeper tear?