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(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, MD
- Review Date: 09/2013
- Update Date: 09/30/2013