Infertility Blogger
Lee Trask is an advocate for women dealing with issues of infertility and miscarriage. Having struggled through more than six years of infertility, three miscarriages, and high-risk pregnancy, she is now happy raising her two…
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Post Episiotomy: What You Need to Know About the Aftermath of the Kindest Cut
Posted in Pregnancy by Lee Trask on Jul 19, 2012
In my last post, I explained a bit about an episiotomy, why it would be used during labor, and why it was the best solution for me during my delivery. What I didn’t touch on was what happens after the cut.

While you are in labor, if you do need an episiotomy, your OB will inject a numbing agent into the perineum tissue before he or she makes the incision. You will not feel the cut or your OB stitching you up.

However, once the anesthetic wears off...whoa nelly. I know everyone’s delivery is different, so I do not intend to say that all women will have the same experience that I had, but there was a sensation after giving birth (for me) which I can only explain as feeling like my insides were dropping out through my vagina. The cut in the perineum only added to the feeling that the stitches were going to give way and, in some cartoon like fashion, the entire contents of my body would be able to fall out onto the floor.

Not going to sugar coat it, the stitches are painful. And they take a while to dissolve as your wound heals. I found it helpful to do a few things to keep the feeling of pressure off the perineum area, and to keep it clean and as “calm” as possible.
- First thing after giving birth: ICE your “delivery area”! You will be given ice packs in the L&D room. Use them. You might not feel pain at first, due to the hormones and anesthesia, but trust me, by the time you do feel it, it will be too late. I made my husband sleep in the room with me, and wake up every two hours and get me fresh ice packs for the first three days (the nurses will be too busy to do this for you.)

- Once you get home, keep icing as needed. You can also use witch hazel pads (found in the drug store.) This is the main ingredient in hemorrhoid pads, and they are used to cool and soothe the area (which will be angry, I assure you.)

- Take pain relievers on schedule. You want to “stay ahead of the pain,” and never get to the point where the pain relievers have worn off completely and you have no relief.

- You don’t want to stretch the area, so do not use a donut ring used for hemorrhoids, this will only allow your perineum to “hang”…you want it supported at all times.

- Squeeze your keegles as you sit down in a chair, or on a bed, etc. to keep the area supported. If sitting is too painful, then adjust to recline.

- Don’t sit on the toilet: hold on to the sink, a towel rack, whatever, and squat while you pee so you aren’t letting the area stretch when you sit on the toilet.

- You definitely need to keep the area clean, so always rinse with a squirt bottle after you pee or poop. Do not wipe!!!! You can also squirt water at your vagina as you pee to take some of the sting out of the pee hitting the stitched area.

- You can also take a sitz baths. This is not your usual deep-water bath, it is a shallow bath of warm water, which increases blood flow to the perineum area, which soothes the area and promotes healing. I remember those baths being heavenly relief.

- DO YOUR KEEGLES. This is SO important. The floor of your perineum has had pressure and weight on it for months, and now it’s been literally cut. You may experience both pee and poop incontinence for a while (I peed my pants every time I sneezed or coughed for a long time.) This incontinence will dissipate, but you need to do your part to help those muscles become strong again. You can do them while you are feeding the baby, or driving in the car, whenever, just do them!

- You will have to wait longer before you can resume sexual intercourse. (Ask your doctor for a time frame.) You may experience pain or discomfort during sex for the first few months. (To be honest, ten years later, I still have occasional pain during sex at my incision area.)

- Lastly, it is important to watch for infection at the suture site. It is an area where lots of germs live, warm and moist…bacteria’s favorite environment. If you suspect infection (the area is hot, more painful than normal, swollen, you run a fever, there is discharge, etc.) see your doctor immediately.
- Lee

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