Many women have an episiotomy during childbirth to prevent injury to the soft tissues of the vagina and the perineum, the area between the vaginal opening and the anus. The procedure involves a clean cut being made in the area that usually heals within four to six weeks after delivery. After an episiotomy, women must be gentle with the area and perform at-home care to ensure the wound heals properly and to minimize the risk of infection, tearing, and other complications. Typical at-home care instructions involve keeping the area clean and dry, preventing strenuous bowel movements, and avoiding sexual activity until the area is healed.
Moist wounds take longer to heal and are at a greater risk of infection, so it is important to keep the perineum dry after an episiotomy to facilitate quick healing. Wearing loose cotton undergarments and exposing the area to air as much as possible helps prevent sweating and excess moisture. The perineum should be washed carefully with a mild soap at least once or twice a day to keep the wound clean and minimize the risk of infection. Women who have had an episiotomy should also take care to dry the area thoroughly, but carefully, after showering.
Applying ice packs to the area helps minimize pain and swelling after an episiotomy. Warm sitz baths in a shallow basin that fits over the toilet help soothe the perineum, but they should be used for no more than 10 to 15 minutes at a time. Some doctors provide women with a liquid numbing spray to help ease episiotomy pain.
Strenuous or difficult bowel movements strain the area between the vagina and the anus, which can result in tearing after an episiotomy. Women should drink several glasses of water each day and strive to consume a diet rich in fiber to help keep bowel movements regular and make it easier to pass stool. A fiber supplement may be needed if the woman's diet does not include enough fiber.
Having sexual intercourse in the first weeks of healing after an episiotomy is not recommended due to the risk of pain, tearing, and infection. The stitches used on an episiotomy usually dissolve within four to six weeks after the procedure. Sexual activity can be resumed at this time provided there are no other complications and intercourse does not cause pain. Using a water-based lubricant can help make intercourse easier after having an episiotomy.