The need for an episiotomy is assessed at the time of birth. It is always dependent on your wellbeing and that of your baby. A few women will have excessive scar tissue from a previous episiotomy and because scar tissue does not stretch these women may need a repeat episiotomy to prevent excessive tearing.
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Toggle navigation. Home Patients Perineal tears and episiotomies in childbirth Episiotomy. Toggle navigation Other pages in this section. In the weeks after giving birth, many women feel sore as well as tired, whether they've had an episiotomy or not.
Do not rush into it. If sex hurts, it will not be pleasurable. If you've had a tear or an episiotomy, pain during sex is very common in the first few months. If penetration is painful, say so. If you pretend everything is OK when it is not, you may start to see sex as a nuisance rather than a pleasure, which will not help you or your partner. You can still be close without having penetration — for example, through mutual masturbation. Pain can sometimes be linked to vaginal dryness.
You can try using a water-based lubricant available from pharmacies to help. Do not use an oil-based lubricant, such as Vaseline or moisturising lotion, as this can irritate the vagina and damage latex condoms or diaphragms.
You can get pregnant just 3 weeks after the birth of a baby, even if you're breastfeeding and your periods have not started again. Use some kind of contraception every time you have sex after giving birth, including the first time unless you want to get pregnant again.
You'll usually have an opportunity to discuss your contraceptive options before you leave hospital if you've had your baby in hospital and at the postnatal check. You can also talk to a GP, midwife or health visitor, or go to a contraception clinic at any time. Find sexual health services near you. Look out for any signs that the cut or surrounding tissue has become infected, such as:. Tell a GP, midwife or health visitor as soon as you can about any possible signs of infection so they can make sure you get the treatment you might need.
Strengthening the muscles around the vagina and anus by doing pelvic floor exercises can help with healing and will reduce the pressure on the cut and surrounding tissue. Pelvic floor exercises involve squeezing the muscles around your vagina and anus as though to stop yourself from going to the toilet or farting.
A midwife can explain how to do the exercises. You can also read this leaflet about pelvic floor exercises for women PDF, 68kb.
For a few women, excessive, raised or itchy scar tissue forms around the place where a tear happened or where an episiotomy was done.
If your scar tissue is causing problems for you, tell your doctor. A midwife can help you avoid a tear during labour when the baby's head becomes visible. The midwife will ask you to stop pushing and to pant or puff a couple of quick short breaths, blowing out through your mouth. This is so your baby's head can emerge slowly and gently, giving the skin and muscles of the perineum time to stretch without tearing. The skin of the perineum usually stretches well, but it may tear, especially in women who are giving birth for the first time.
An episiotomy is when a midwife or doctor needs to cut the area between your vagina and anus the perineum during childbirth, to help deliver your baby. You might have needed this if your baby had to be born quickly or if forceps were required NICE, It can take up to a month for your episiotomy to heal and for your stitches to dissolve. Rest is really important and will help your body recover and heal from an episiotomy. Some of the following episiotomy self-care suggestions might help to relieve pain:.
It can be uncomfortable going to the toilet while you are recovering from an episiotomy. Occasionally, women experience complications after an episiotomy. Tell your GP, midwife or health visitor as soon as you can about any possible signs of infection, so they can make sure you get treatment.
For a few women scar tissue following an episiotomy can cause problems. Excessive, raised or itchy scar tissue can sometimes form where an episiotomy was. If your scar tissue is causing problems for you, talk to your GP. Most women who have an episiotomy say that having sex again after it is very painful, but that this improves with time. Read our article about having sex after having a baby. Having an episiotomy or tear can be a sensitive subject for some women. Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: You might find attending one of our Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.
Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby. NHS Choices. Beckmann M, Stock O. Cochrane Database Syst Rev.
Frolich, Kettle. BMJ Clin Evid.
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