Routine Episiotomy: What to Know

The perineum is the tissue between the vaginal opening and anus. If an episiotomy is needed, a clinician makes the incision during labour, then closes it with stitches after birth. It may be discussed when the baby needs to be born quickly, assisted vaginal birth is planned, or severe tearing appears more likely in the circumstances.

A cut does not prevent every tear and is not suitable for every birth. The decision depends on the baby’s position and wellbeing, the stage of labour, your anatomy, and your preferences. Ask for an explanation before consent whenever there is time.

Keep the area clean and dry according to your maternity team’s instructions. Wash gently, change pads regularly, rest when possible, and use the pain relief or cold packs recommended for you. Avoid straining with bowel movements; fluids, fibre, and prescribed stool softening may help.

The stitches usually dissolve as the tissue heals. Follow-up can address pain, wound healing, scar sensitivity, bladder or bowel symptoms, and return to sex or exercise. Perineal repair may be part of this recovery care.

Contact your maternity team promptly for worsening pain, increasing swelling, wound separation, pus or a bad smell, fever, heavy bleeding, difficulty passing urine, or loss of bowel control. Seek urgent help if you feel very unwell, faint, or develop rapidly increasing bleeding.

Ask what specific concern would make an episiotomy useful, which alternatives may be possible, how the incision would be repaired, and what recovery restrictions apply. After birth, ask how the wound is healing and when to return for review.