Third-degree episiotomy: what to know

An episiotomy is a planned cut in the perineum to widen the vaginal opening during birth. A third-degree injury reaches the muscle that helps control the anus. It is repaired with stitches, usually after the birth, and the repair needs time to heal. Soreness, swelling, difficulty sitting, and fear of bowel movements can occur early on, but worsening pain, loss of bowel control, or trouble passing stool should not be ignored.

Follow the discharge instructions for wound care and prescribed medicines. Keep the area clean, change pads regularly, drink fluids, and use the bowel-softening plan provided by your maternity team so straining is reduced. Rest while gradually increasing activity, and avoid lifting or exercise that causes pain until advised. A follow-up review checks healing and continence. Perineal repair provides further information about the repair and aftercare.

Contact your maternity team promptly for increasing pain, spreading redness, wound opening, pus, fever, heavy bleeding, difficulty urinating, or an offensive smell. Seek urgent help for inability to control stool or gas, severe weakness, or rapidly worsening symptoms. Emotional distress, fear of intimacy, or persistent pain also merits support; these are valid reasons to arrange a review.

Ask which muscles were involved, how to protect the repair during bowel movements, when driving and sex may be comfortable, and which symptoms mean the wound needs examination. Ask when continence and healing will be reviewed.