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Episiotomy: what, why, and how to recover

An episiotomy is a cut to the skin between the vagina and the anus (the perineum) to help make the opening a bit wider for the baby to come through during childbirth. These cuts are small and are made during the pushing phase of labour by a doctor or a midwife.

Episiotomies are performed much less frequently than they used to be. In 2000, for example, 33% of vaginal births involved an episiotomy whereas in 2021, just 12% did. Nowadays, episiotomies are not done routinely in the UK.

However, an episiotomy is still recommended if:

  • The baby is in distress and needs to be born quickly.
  • The baby will be delivered with the help of forceps or ventouse.
  • There is a risk of a tear to the anus.

If you’ve had an episiotomy and are unsure why it happened, you can contact your midwife, doctor, or hospital to ask.

Usually, women do not feel the cut of an episiotomy. A local anaesthetic is used to numb the area or, if you have an epidural, your dose can be topped up before the procedure.

If you have an episiotomy, you’ll probably need stitches to mend the cut. This will happen within the first hour after your baby is born. These are usually dissolvable stitches so that you don’t have to return to hospital to have them taken out.

Stitches should heal within one month of birth. In this time, it’s important to keep the cut clean to prevent infection. You can use painkillers to help with the pain, but it’s a good idea to check with your doctor first about which ones are most suitable for you. Going to the toilet can be uncomfortable while recovering, but pouring warm water over the area as you pee can help, as well as pressing on the area with a clean pad when you poo.

You should call your midwife or GP if your stitches get more painful, if there’s red or swollen skin around the cut, or if there’s smelly discharge from your vagina or cut.