Is episiotomy better than tearing? Why is episiotomy not recommended anymore? When does episiotomy stop hurting? What are the signs that it’s healing?
Childbirth is a beautiful, albeit challenging, experience. It brings about a whole range of emotions, from excitement to anxiety. But beyond the emotional toll it takes, it can also take a physical toll on the mother’s body. One of the most common interventions during childbirth is an episiotomy.
“I was really nervous about having an episiotomy, but my doctor explained that it was necessary to help the baby come out safely. The recovery was tough, but I followed my doctor’s instructions and took care of the area as best I could. It took a few weeks, but eventually, the pain subsided, and I felt like myself again,” wrote one mum.
Aside from the pain, one of the things that may cause anxiety among women about childbirth can be getting stitches down there, better known as an episiotomy. One reason for this may be that they don’t know what to expect with the whole process – will it hurt? Will it affect their recovery?
In this article, we’ll try to provide answers to your burning questions about this topic. We’ll explore what an episiotomy is, who gets one, the risks of not properly caring for it, and how to take care of it.
Table of Contents
What is an Episiotomy
First things first, what is an episiotomy? An episiotomy is a surgical incision made in the perineum, the area between the vaginal opening and the anus, to widen the vaginal opening during childbirth. It is usually done to prevent the tearing of the perineum and to make it easier for the baby to be born.
The procedure is usually done when the baby is in distress or when the mother is having difficulty pushing the baby out. However, it is worth noting that not all women require an episiotomy during childbirth.
Why Is Episiotomy Not Recommended Anymore?
In recent years, the practice of episiotomy, once a common procedure during childbirth, has fallen out of favour in the medical community. Episiotomy involves making a surgical incision to enlarge the vaginal opening during delivery.
While it was believed to prevent severe tearing and promote quicker healing, contemporary medical evidence suggests otherwise. Research now indicates that routine episiotomy does not necessarily reduce the risk of severe tearing and can lead to complications, such as increased pain during recovery and a higher likelihood of infection.
Consequently, healthcare providers are moving away from routine episiotomy and opting for more conservative approaches, like perineal massage and controlled pushing techniques. This shift aligns with the goal of providing women with safer and more evidence-based childbirth experiences.
Who Gets an Episiotomy?
While it used to be a routine procedure during childbirth, the American College of Obstetricians and Gynecologists (ACOG) now recommends that episiotomies should only be done when medically necessary.
According to ACOG, episiotomies are recommended in cases where the baby is in distress and needs to be delivered quickly or when the mother’s tissues are not stretching enough to allow for a safe delivery.
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Some studies have shown that routine episiotomies may cause more harm than good. For instance, a study published in the Journal of the American Medical Association found that routine episiotomies were associated with an increased risk of severe perineal tears and a longer healing time compared to selective episiotomies.
Therefore, it’s important to discuss with your healthcare provider whether an episiotomy is necessary in your case.
Will It Hurt?
It is common for women to feel some discomfort during and after the procedure. During the procedure, a local anaesthetic may be used to numb the area, but some women may still feel some pressure or discomfort. After the procedure, it is common for women to feel pain or discomfort in the area. However, there are several ways to manage the pain,
Risks of Having an Episiotomy
Now, let’s talk about the risks of not properly caring for an episiotomy. After childbirth, the perineal area may be sore, swollen, and tender. It’s important to properly care for your episiotomy to prevent infection, promote healing, and alleviate pain. Neglecting proper care can lead to complications such as infection, prolonged healing time, and increased pain.
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How to Care for Your Episiotomy
“I wasn’t expecting to have an episiotomy, but my son was in distress, and it was the safest option. The recovery was definitely not easy. The first few days, I could hardly sit down, and going to the bathroom was excruciating.
But I took it day by day, used ice packs and warm compresses, and eventually, the pain lessened. It was a challenging experience, but in the end, it was worth it to have a healthy baby,” shared Rachel, a mum of one.
Looking after your postpartum stitches is very important to ensure a smooth recovery. Here are some tips for properly caring for an episiotomy after childbirth:
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Keep the area clean and dry: Use a peri-bottle filled with warm water to clean the area after using the toilet. Change your pad frequently to keep the area dry.
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Avoid using harsh soaps or perfumes: These products can cause irritation and delay healing.
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Apply ice packs to reduce swelling and relieve pain: Apply ice packs to the area for the first few days after childbirth.
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Use warm compresses after the first few days: Warm compresses can help promote blood flow to the area and alleviate pain.
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Practice good hygiene to prevent infection: Always wash your hands before and after caring for your episiotomy. Avoid using tampons, douches, or any other products that can irritate the area. Wear loose-fitting clothing to allow air to circulate around the area.
By following these tips, you can help ensure a smooth and healthy recovery after childbirth. Remember to take it slow, listen to your body, and don’t hesitate to reach out to your healthcare provider if you have any concerns.
Signs that Your Episiotomy is Healing
So, how do you know that your stitches down there are on the road to recovery? Here are some signs to look out for:
- Decreased pain and discomfort in the perineal area
- Reduced swelling and tenderness
- Healing of the incision site, with the edges coming together
- Absence of redness, warmth, or pus at the incision site
- Gradual fading of bruising or discolouration
- Improved ability to sit, walk, and move without pain
- Increased comfort during urination and bowel movements
- Decreased reliance on pain medication for relief
- The gradual return of normal perineal sensation
- Resumption of sexual activity without discomfort or pain
How Long After Episiotomy Can You…
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1. Stand?
You can typically start standing and moving around shortly after an episiotomy. Listen to your body and gradually increase your activity level as you feel comfortable.
2. Walk?
Walking is encouraged as part of the postpartum recovery process. You can begin walking short distances as soon as you feel ready. Start with gentle walks and gradually increase your walking duration and intensity.
3. Carry your baby?
It is generally recommended to wait until the episiotomy has fully healed before carrying your baby for extended periods or engaging in activities that may strain the perineal area. Your doctor will assess your specific situation and provide personalised instructions regarding activities like carrying your baby.
4. Exercise?
It’s important to consult with your healthcare provider before starting any exercise routine after an episiotomy. Generally, low-impact exercises, such as pelvic floor exercises, gentle stretching, and light aerobic activities, can be started a few weeks after the procedure. However, it’s essential to listen to your body and avoid any exercises that cause pain or discomfort.
5. Have Sex?
It’s recommended to wait until your episiotomy has fully healed before resuming sexual activity. This typically takes about 4 to 6 weeks, but it may vary for each individual. It’s important to have an open conversation with your healthcare provider about when it is safe to engage in sexual intercourse again.
Remember to always follow the guidance of your healthcare provider and listen to your body’s cues during the recovery process.
When to Go to the Doctor
Meanwhile, here are 3 signs that indicate you should go to the doctor for your episiotomy after childbirth:
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Fever: If you experience a fever, it could be a sign of an infection. Contact your healthcare provider immediately.
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Increased pain: Some pain and discomfort are normal after childbirth and an episiotomy, but if you experience increased pain, it could be a sign of an infection or other complication. Contact your healthcare provider if you are concerned.
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Discharge: If you notice any unusual discharge, such as pus or a foul odour, contact your healthcare provider. It could be a sign of an infection or other complication.
Remember to take care of your episiotomy properly by following the recommended care tips and hygiene practices. However, if you experience any of these signs or have any concerns, do not hesitate to contact your healthcare provider for advice and treatment.
Childbirth is a beautiful experience, but it can also be a challenging one. Knowing how to properly care for your body after childbirth, including your episiotomy if you have one, is essential to a smooth and healthy recovery. With the right care and support, you can enjoy the joys of motherhood without any unnecessary complications.
Image Source: iStock
Here at theAsianparent Singapore, it’s important for us to give information that is correct, significant, and timely. But this doesn’t serve as an alternative for medical advice or medical treatment. theAsianparent Singapore is not responsible for those that would choose to drink medicines based on information from our website. If you have any doubts, we recommend consulting your doctor for clearer information.