Perineal Repair

The perineum is the skin and muscle between the vaginal opening and anus. During birth it can tear, or a planned cut called an episiotomy may need closing. Repair uses dissolvable stitches after the extent of the injury is checked.

The clinician explains the injury, checks bleeding and offers pain relief or local anaesthetic. More extensive injuries may need repair in an operating theatre by a specialist team.

You are first examined in good light, with consent and an explanation of findings. The area is cleaned and numbed, then tissue layers are aligned and stitched. The team checks bleeding, comfort and the final repair, and gives instructions for hygiene, pain relief and follow-up.

Repair is intended to restore injured tissue and control bleeding; the procedure concerns your perineum after birth, so it does not expose the baby to the stitching itself. Your team balances anaesthetic, bleeding, infection, pain and the depth of the tear, and will escalate care if the injury is extensive.

You can ask what was injured, why repair is recommended, which pain-relief options are available and whether specialist repair is needed. The choices may include bedside repair, theatre-based repair, or observation for a very small superficial injury when a clinician confirms stitches are unnecessary.

Keep the area clean and dry as advised, change pads regularly and take recommended pain relief. Avoid constipation and straining by following the care plan. Worsening pain, fever, offensive discharge, opening of the wound or difficulty controlling urine or stool needs prompt review.

Repair may be recommended after a tear that is deep, bleeding, gaping or affecting muscle, or after an episiotomy. A small skin graze may not need stitches if its edges are together and bleeding is controlled; the birth team decides after examination.

The clinician confirms the injury and your identity, explains the plan and checks your anaesthetic is working. They gently clean the area, repair deeper muscle layers first when needed, then close the skin. A final examination checks the repair and bleeding before you return to postnatal care.

Soreness, bruising and a pulling feeling can occur early on. Stitches soften and dissolve as the wound heals. Gradually increasing walking is usually encouraged, while comfort, bowel movements and pelvic-floor symptoms guide follow-up. Persistent pain or painful sex should be discussed rather than endured.

Possible problems include pain, bruising, infection, bleeding, wound separation, scar tenderness or pelvic-floor symptoms. A deeper tear can affect anal control and may need specialist follow-up. Seek urgent assessment for heavy bleeding, faintness, severe worsening pain or feeling acutely unwell.

The appropriate option depends on the injury. Observation may suit a minor, closed graze; repair is needed when tissue requires alignment or bleeding control. A planned episiotomy is different from repairing a tear, although either can require stitches after birth.

Choose a maternity service with access to examination, pain management, pelvic-floor advice and specialist review for complex tears. At follow-up, mention pain, bladder or bowel changes, wound concerns and questions about returning to sex or exercise.