Northside Health Library

Episotomy - aftercare


An episiotomy is a minor surgery that widens the opening of the vagina during childbirth. It is a cut to the perineum, which is the skin and muscles between the vaginal opening and anus.

What to Expect

Most women heal without problems, although it may take many weeks.

Your stitches do not need to be removed. Your body will absorb them. You can return to normal activities, such as light office work or house cleaning, when you feel ready. Wait 6 weeks before you:

  • Use tampons
  • Have sex
  • Do any other activity that might rupture (break) the stitches


To relieve pain or discomfort:

  • Ask your nurses to apply ice packs right after the birth. Using ice packs in the first 24 hours after birth decreases the swelling and helps with the pain.
  • Take warm baths, but wait until 24 hours after you have given birth.
  • Take medications like ibuprofen to relieve pain.

You can do many other things to help speed up the healing process. These include:

  • Use sitz baths (sit in water that covers your vulvar area) a few times a day. Wait until 24 hours after you have given birth to take a bath. You can buy tubs in any drug store that will fit on the rim of the toilet, and you can sit in these instead of climbing into the bathtub if you prefer.
  • Change your pads every 2 - 4 hours.
  • Keep the area around the stitches clean and dry. Pat the area dry with a clean towel after you bathe.
  • After you urinate (pass water) or have a bowel movement, wipe from front to back. Spray warm water over the area and pat dry.

Take stool softeners and drink lots of water. This will prevent constipation (not being able to move your bowels). Eating lots of fiber will also help. Your doctor can suggest foods with plenty of fiber.

Do Kegel exercises. Squeeze the muscles that you use to hold in urine for 5 minutes. Do this 10 times each day throughout the day.

Call Your Doctor If

  • Your pain gets worse
  • You go for 4 or more days without a bowel movement
  • You pass a blood clots larger than a walnut
  • You have a discharge with a bad odor
  • The wound seems to break open

Review Date: 4/22/2012
Reviewed By: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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