An episiotomy is a small surgical incision of the perineum. The perineum is the skin between your vagina and anus. A lot of pressure is exerted on this part of your body during labour, meaning the perineum can tear. An episiotomy is a way to prevent tearing by making a deliberate surgical incision first. Opening the space in this way can make it easier to push when the time comes, and a cut may be smaller than a natural tear.
Episiotomies and natural tearing are normal, though it can be a daunting thought going into childbirth. It’s okay – a perineum tear is manageable and with proper care can heal in 2 months. If you can handle giving birth, you can handle this!
If you’re wondering whether or not you’ll need an episiotomy, the answer is: maybe. Episiotomies are a preventative measure. It’s up to you and your doctor whether you want or needs one, so be sure to discuss this beforehand.
According to 2018 statistics, over 85% of vaginal births can result in a perineal tear. No need to panic – tearing is classified in 4 degrees of severity, and most tears are not severe. 3rd to 4th-degree tears make up only 0.6-11%, and these can eventually heal too.
First-degree tears sometimes heal all on their own! Larger tears or episiotomy incisions can be stitched up post-birth. Remember that the perineum can heal back to normal. Here’s how to care for your perineum after labour:
- Rest. Laying down reduces the pressure on your perineum. Avoid sitting positions or standing for too long. If you’re nursing, try breastfeeding on your side to help ease discomfort.
- Ice. For the first three days or so after giving birth, icing the area can help with bruising, swelling and pain. Try 10-20 minute intervals.
- Pain relief like paracetamol can be helpful, but be sure to talk to your doctor first about which medication is best for you.
- Hydration and a good diet. Making your stool softer and easier to pass can reduce trauma to your perineum during bowel movements post labour. Drink lots of water and eat lots of fibre.
- Use warm water. A helpful tip for when urinating is to pour warm water on the area. This dilutes the urine and decreases potential stinging sensations. Gently pat dry rather than rubbing the sensitive area.
- Exercises. Pelvic floor exercises like Kegel’s and Glute Bridges can help strengthen this area. Consult your doctor or physiotherapist about which exercises are safe for you.
Ways to reduce the need for an episiotomy:
Massaging the perineum during later pregnancy may reduce the risk of tearing or requiring an episiotomy. Pelvic floor exercises may also help. Massaging or placing a warm compress to this area during labour may also help. Your midwife, nurse or doctor can assist with this.
Remember to listen as best as you can to your doctor or midwife as they coach you through controlled pushing. Your body is capable of incredible things – you’re making a person! If you do need an episiotomy, your body will be okay.