About Episiotomy Postpartums

Function

An episiotomy is a small incision to the perineum for the purpose of speeding up a baby's birth or making the delivery easier. The perineum is the muscle area between the anus and the vagina. An episiotomy is performed when the baby's head is crowning and and the episiotomy incision is stitched closed a few minutes after the delivery.
Episotomies are used to prevent perineal tearing during childbirth. However, many health care professionals now believe episiotomies create additional postpartum issues and should only be used when medically necessary.

The two most common types of episiotomies are the midline and the mediolateral episiotomy. The midline is an incision that starts at the bottom of the vagina and makes a straight line in the direction of the anus. The mediolateral episiotomy involves an incision from the bottom of the vagina at a right or left angle toward the anus.

Healing from an episiotomy can be painful but there are steps that can be taken to reduce discomfort.
While still in the recovery area, request ice packs and place them on the perineum to reduce swelling and inflammation. Pour warm water over the perineum whenever you urinate to reduce stinging. Sit on a doughnut shaped ring to relieve pain through reduced pressure. Take over the counter pain relievers at regular intervals. Using a witch hazel spray on the area will soothe pain as well as speed up the healing process.

Take several sitz baths a day to promote healing. Remember to only stay in the water for a few minutes at a time because soaking for too long can cause the stitches to become soggy which increases the risk of infection. Place hemorrhoid pads against your perinium and hold in place with a sanitary pad to provide soothing relief and encourage healing. Change them whenever you change your sanitary pad. Change your sanitary pad every three to four hours to keep area clean and dry. Pat dry after baths and urinating so that stitches stay in place and skin is not irritated. Perform up to 100 kegel exercises a day. They increase blood flow to the area which speeds the healing process. Avoid standing or sitting for long periods at a time.

Episiotomies were very popular in the 1970's and 1980's and were believed to reduce postpartum complications. Today, much of the medical community believes they should only be performed in medically necessary situations. The healing time can be long, and scar tissue can create problems years later. If you have an episiotomy, taking steps to prevent infection can reduce your healing time and increase your comfort level following the delivery of your child.

Call your doctor if you develop a fever or the site becomes swollen, red or irritated. Episiotomy complications can appear years after they are healed. Research has indicated problems with bowel movements, bowel control, bladder control and issues with intercourse due to damage in various areas of the rectum, sphincter and vagina during an episiotomy.