What Should I Know about Episiotomy Stitches?

Drue Tibbits
Drue Tibbits
Equipment used to place and remove stitches.
Equipment used to place and remove stitches.

An episiotomy is the surgical cutting of the perineum, the skin below the vaginal opening, in the course of childbirth. Episiotomy stitches are surgical sutures that close the incision so that it can heal properly. The stitches usually dissolve, and the incision heals within about six weeks. Proper care of the stitches and the surrounding area is necessary to avoid infection or complications.

One factor that determines if an episiotomy is performed include the position of the baby during birth.
One factor that determines if an episiotomy is performed include the position of the baby during birth.

Some doctors routinely perform episiotomies to prevent tearing of the perineum as a tear is harder to suture than a surgical incision. Not all childbirths require episiotomies. Some of the factors that determine if an episiotomy is performed include the position of the baby during birth, existing scar tissue on the perineum, and previous uterine prolapse. Prior to childbirth, there are things that can be done to limit the need for an episiotomy. Perineum massage will help keep the perineum elastic and able to stretch during childbirth, and Kegel exercises strengthen the perineum muscles.

Performing gentle stretching and kegel exercises during pregnancy may help strengthen the perineum muscles.
Performing gentle stretching and kegel exercises during pregnancy may help strengthen the perineum muscles.

The procedure takes about 10 to 20 minutes and is usually performed at the point in childbirth when the physician can see the baby’s head. A local anesthetic may be applied to the perineum. The physician then makes a short incision, either straight down toward the anus or at a slight angle. After the birth, the physician cleans the incision and closes it with several episiotomy stitches. The stitches are made of an absorbable material and will not need to be removed later.

Any perineal incision is typically closed using dissolving sutures.
Any perineal incision is typically closed using dissolving sutures.

Episiotomy stitches and the surrounding skin should be kept clean with warm water and unscented soap. To help with healing, the stitches should be exposed to the air at least a couple of times a day for at about 10 minutes each time. Regular hand washing will help prevent an infection, particularly before touching the area and before using the bathroom. Patients should abstain from intercourse for about eight weeks in order to give the episiotomy incision time to heal completely.

Patients should abstain from intercourse for about eight weeks following an episiotomy.
Patients should abstain from intercourse for about eight weeks following an episiotomy.

Complications after episiotomies are uncommon. Patients should monitor the stitches until the episiotomy incision is healed. The stitches may cause pain, fall out, or become infected. A patient should notify her doctor if the stitches remain painful after the first week, if they become dislodged or fall out, or if there is an unusual discharge from the stitched skin. The episiotomy stitches may sting during urination, and pouring warm water on the area during and after urination can provide some relief.

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Discussion Comments

burcinc
@anamur-- I think the pain gets worse after the first few days because the incision area tends to open a bit while it heals.

Have you tried salt water baths? Salt water baths are great, they help with the pain a lot. You can also try witch hazel. Apply some to the area with a cotton ball, or you can just use witch hazel pads.

I've heard of people using tea tree oil, in baths or diluted with other oils but I've never used it myself.

serenesurface

My stitches are in the process of dissolving and I know I don't have an infection, but I'm experiencing a lot of pain! I thought it would get better, but the last few days have been even more painful.

fify

My mom had an episiotomy while giving birth to my brother. He was a big boy and the doctor had to do some cutting.

I feel scared about my pregnancy when my mom talks about her episiotomy. I hope I won't have to have one. My mom said that she had perineal pain for months after the procedure. She also had to be very careful with hygiene to prevent infection. Since the stitches are so close to the rectum, risk of infection is high.

Apparently, women are also not supposed to get constipated until the stitches dissolve and completely heal. It cannot be fun to deal with all this immediately after giving birth.

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    • Equipment used to place and remove stitches.
      Equipment used to place and remove stitches.
    • One factor that determines if an episiotomy is performed include the position of the baby during birth.
      One factor that determines if an episiotomy is performed include the position of the baby during birth.
    • Performing gentle stretching and kegel exercises during pregnancy may help strengthen the perineum muscles.
      Performing gentle stretching and kegel exercises during pregnancy may help strengthen the perineum muscles.
    • Any perineal incision is typically closed using dissolving sutures.
      Any perineal incision is typically closed using dissolving sutures.
    • Patients should abstain from intercourse for about eight weeks following an episiotomy.
      Patients should abstain from intercourse for about eight weeks following an episiotomy.
    • An episiotomy refers to the surgical cutting of the perineum in the course of childbirth.
      An episiotomy refers to the surgical cutting of the perineum in the course of childbirth.
    • A episiotomy is usually performed if there was previous uterine prolapse.
      A episiotomy is usually performed if there was previous uterine prolapse.
    • Regular hand washing will help prevent an infection following an episiotomy.
      Regular hand washing will help prevent an infection following an episiotomy.
    • An episiotomy may be performed if a baby appears too large during the birthing procedure.
      An episiotomy may be performed if a baby appears too large during the birthing procedure.