If your doctor or midwife performed an episiotomy during childbirth, you’ll need extra postpartum care to facilitate healing and minimize discomfort or pain. Episiotomies result in a minor incision to the vagina, widening the opening to prevent severe perineum tears.

NOTE: If you haven’t yet gone into labor, discuss the use of episiotomy with your delivery team beforehand. Current reviews of multiple, controlled research trials show episiotomies should be used selectively and only when necessary.

There are times when an episiotomy is necessary and that leads to a more tender, postpartum recovery.

How to Heal an Episiotomy After a Vaginal Birth

The following care techniques alleviate the pain and swelling that results from an episiotomy, and will also encourage faster healing.

Immediately after the episiotomy

Ask your nurse to apply ice packs to the episiotomy site for the first several hours after birth. These packs should be intermittently during the first 24-hours.

At-home Care for episiotomy

Make your own, comfortable episiotomy ice packs.

You can purchase special, perineal cold packs at your local pharmacy. Or, you can make your own ice packs for use at home using:

  • Incontinence padsepisiotomy
  • Water
  • Witch hazel in a spray bottle
  • Gallon-sized, resealable bags

These pads are a great addition to your Preparing for Childbirth” list. Read how to make them here.

Spray and pat – don’t wipe!

You’ll be provided with a small plastic squirt or spray bottle. For the first week or so (or until your doctor says so) spray water over the perineum area after urinating or after a bowel movement and pat dry. Do not wipe with toilet paper.

Take Sitz baths

After the first 24-hours, Sitz baths are a wonderful way to soothe and heal sore and battered nether-regions. You can buy soothing Sitz baths formulas online or at your local health food store. You can also make your own.

Make sure your bathtub is clean. Fill it with warm water and add a Sitz bath infusion (directions are provided on packaging). You can also use a Sitz “tea” in the water bottle provided by your doctor or nurse to cleanse the area after using the toilet.

Take an anti-inflammatory

Speak with your doctor or midwife about an over-the-counter, anti-inflammatories, like ibuprofen, which are fine to take (as directed) while breastfeeding.

Keep the area clean and dry

Make sure you’re changing pads as directed – every two to four hours – and that the perineum is kept clean and dry. This prevents further irritation or infection.

Eat lots of fiber

Eat lots of fruits, veggies and high-fiber foods to keep your stool as soft as possible. Use a stool softener if necessary.

When to Call the Doctor

Do call the doctor or a healthcare provider if you notice the following signs:

  • Increasing pain
  • You haven’t had a bowel movement in more than three days
  • Discharge is discolored and/or has a bad odor
  • You pass a blood clot that’s bigger than a walnut
  • Your wound has reopened

Concerned your episiotomy isn’t healing like it should? Contact us here at Overlake and we’ll get you in right away.