What should you know about suture episiotomy?

An episiotomy is a deliberate cut in the perineum, the tissue between the vaginal opening and anus, made during some births. The repair brings the separated tissue edges together so they can heal. The thread is usually absorbed by the body, so removal is not normally needed. Tenderness, tightness, bruising and a pulling feeling when sitting or walking can occur during early recovery.

Healing can be affected by the size and position of the cut, childbirth-related swelling, bowel movements and the condition of the skin. A small amount of spotting can be expected after birth, but worsening pain or a change in the wound needs attention.

Keep the area gently clean with water and pat it dry rather than rubbing. Change maternity pads regularly, wash your hands before and after pad changes, and use the pain relief recommended by your maternity team. Rest when possible, avoid straining during bowel movements, drink fluids and include fibre in meals. A wrapped cool pack used briefly may ease swelling.

Follow the specific advice given after delivery about bathing, activity and sex. Do not pull at visible thread or apply products to the wound unless a clinician has advised it. More detail is available in [Perineal Repair].

Contact your maternity unit promptly if pain is becoming stronger, the wound opens, the area becomes increasingly red or swollen, or you notice pus or an unpleasant smell. Seek urgent help for heavy bleeding, fever, feeling faint, or severe illness. New difficulty controlling urine or stool, or inability to pass urine, also needs assessment.

Ask how the repair is healing, which pain medicines are suitable if you are breastfeeding, when to resume activity and sex, and what changes should prompt a review. If discomfort continues, ask whether pelvic-floor support or a wound examination is appropriate.