We explore what an episiotomy is, does an episiotomy hurt and can it be avoided?
What is an episiotomy?
An episiotomy is a surgical cut to your perineum, which is the muscular area between your vagina and back passage. This cut helps if there are concerns about you or your baby.
Why might I need to have an episiotomy?
Your midwife or obstetrician should only offer you an episiotomy if she feels that you will benefit from having the procedure. An episiotomy is not a routine part of labour and may cause more harm than good if it’s not necessary.
Saving episiotomy for only when it is really needed means that you will have:
- Less damage to your perineum
- A lower risk of needing stitches
- Fewer problems with healing
- Even if you have a tear while giving birth, it can be less painful and heal better than a cut.
However, your midwife or doctor may suggest that you have an episiotomy if:
- Your baby is distressed and needs to be born quickly
- You’ve been pushing for a long time and need an assisted birth
Can an episiotomy be avoided?
When you are in labour, these self-help measures may help you to avoid an episiotomy:
- Using relaxation techniques
- Being in upright positions
- Lying on your side if you’ve had an epidural
During your pregnancy, go along to all your antenatal classes so you can learn about preventative measures. Perineal massage and good breathing techniques could help you during the pushing stage.
Does an episiotomy hurt?
If you don’t already have an epidural in place, your midwife /doctor will give you a local anaesthetic in your perineum. Having an anaesthetic means you will only feel minimal discomfort. The tissues around the vagina are tightly stretched during the birth, so it’s easy for your midwife/doctor to make the cut.
Your doctor/ midwife will put in stitches after you’ve delivered the placenta. In some hospitals, you may need to be wheeled into the operating theatre where the lighting and facilities are better. If allowed for better pain relief and positioning, the local anaesthetic should mean you should feel no pain at all during stitching. If you feel pain during stitching, tell your midwife/ doctor that you need more pain relief immediately.
Recovering from an episiotomy can be quite painful, though, so you’ll need to have regular pain relief. Hygiene after an episiotomy is very important to prevent infection. Washing your hands before and after changing your pads is essential.
These tips can help to relieve pain and discomfort following an episiotomy:
- Using a doughnut-shaped cushion or squeezing your buttocks together while you are sitting may also help to relieve the pressure and pain at the site of your cut.
- Placing an ice pack or ice cubes wrapped in a towel on the incision can often help to relieve pain. Avoid placing ice directly on to your skin because this could damage it.
- Keep the cut and the surrounding area clean to prevent infection. After going to the toilet, pour lukewarm water over your vaginal area to rinse it.
- Ask your midwife for pain relief.
More like this:
Labour pain relief options
Outlining your birth preferences
Water birth – what to expect