(Perineum Incision; Incision, Perineum)
Reasons for Procedure
The baby is:
- Premature or otherwise fragile
- Large and the shoulders may be hard to deliver
- Forceps or a vacuum are needed to assist in the delivery
- Difficulty controlling your bowels
- Severe scar tissue in the area
- Prior problems with chronic pain in the vulva
- Short perineum
What to Expect
Prior to Procedure
Description of the Procedure
- Midline incision: starts at the vagina and follows a straight line to the anus
- Mediolateral: starts at the vagina and continues at an angle
|Midline vs. Mediolateral Episiotomy|
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How Long Will It Take?
Will It Hurt?
Average Hospital Stay
- For the first 24 hours after delivery, apply ice. Wrap the ice in a towel. Do not apply it directly to your skin.
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
- When your doctor says it is okay, take a sitz bath several times each day. This involves immersing your hips and buttocks in water. Cool water may help to relieve discomfort.
- Do not strain when moving your bowels. Your doctor may ask you to take a laxative or stool softener.
- Use a spray bottle of water to clean the area after going to the bathroom.
- Use spray, medicated pads, or medicine as directed by your doctor.
- When your doctor tells you to, do Kegel exercises. Simply squeeze the muscles you use to stop the flow of urine. This strengthens the pelvic floor and can help the area heal faster.
- Avoid having sex, douching, and using tampons for six weeks or as directed by your doctor.
- Be sure to follow your doctor’s instructions.
Call Your Doctor
- Signs of infection, including fever and chills, swelling, redness, foul-smelling discharge
- Pain that you cannot control with the medicines you have been given
- Bleeding from the episiotomy site
- Continuing problems with loss of urinary or bowel control
American College of Nurse-Midwives http://www.midwife.org
American Congress of Obstetricians and Gynecologists http://www.acog.org
The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org
Women's Health Matters http://www.womenshealthmatters.ca
Episiotomy. ACOG practice bulletin No. 71. Obstet Gynecol. 2006;107:957-962.
Episiotomy. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/labornbirth/episiotomy.html. Accessed August 13, 2012.
Episiotomies. Brigham and Women's Hospital website. Available at: http://www.brighamandwomens.org/departments%5Fand%5Fservices/obgyn/services/midwifery/patient/episiotomies.aspx. Accessed August 13, 2012.
- Reviewer: Andrea Chisholm
- Review Date: 09/2012 -
- Update Date: 00/91/2012 -
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
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