How to Handle an Episiotomy

Episiotomy occurs during the second stage of labour to help in childbirth. It is the cutting of the vagina opening during a difficult birth, a process many women go through. In Kenya, it’s considered a usual process; especially because expectant mothers are not given a chance to opt against it. It may seem like a painful procedure, but given the circumstances, a woman barely feels it. Private hospitals in Kenya may offer a numbing shot, while public birthing centres do not. Let’s talk more about episiotomy and its implications. 

What is Episiotomy?

An episiotomy is a surgical process that involves cutting through the vaginal wall and the perineum. The perineum is the space between the thighs that extends from the opening of the vagina to the anus. It helps in enlarging the vaginal opening to help during a difficult childbirth. 

The incision happens after the vaginal opening stretches a few centimetres during contraction. It may be made at an angle or in a straight line. Most doctors opt for the angled cut to avoid tearing through the anus. However, the angled cut may take more time to heal. The incision will then be stitched closed.

Reasons for an Episiotomy

Recent studies show that avoiding an episiotomy during labour is best. In fact, The American College of Obstetricians and Gynecologists (ACOG) no longer endorses carrying out an episiotomy routinely. However, there are circumstances that may lead to a woman needing an episiotomy such as:-

  • Your vagina may not stretch enough to allow the foetus through
  • The foetus’ head or shoulders cannot fit the opening
  • Need to speed up the delivery because either your baby or you is in distress
  • Inability to slow or stop pushing
  • In case of complications such as a breech birth

Please ensure that you consult your doctor regarding the best option for treatment. 

How to Avoid Having an Episiotomy

  • Do some Kegel exercises
  • Attend birthing classes to learn how to breath and control your pushing
  • Massaging the perineum area during the last six weeks before delivery

Healing From an Episiotomy

If you’ve already had the procedure, there are ways to help you heal better and faster. You need to take good care of yourself to avoid tearing the stitches. Below are some of the ways to care for and heal an episiotomy.

  • Sit on a sitz bath or warm salty water at least twice a day. Though not specified, there are controversies around how much salt to use. Please consult your doctor about this
  • Apply ice packs to the area to avoid swelling
  • Avoid squatting
  • Gently hold the stitched area with a clean warm cloth during bowel movements to avoid straining the stitches
  • Take stool softeners to avoid painful bowel movements. Get a doctor to recommend the stool softeners if needed.
  • Keep the area clean and dry by using a clean cloth or gauge (avoid using tissue).


#Please note that development differs from one child to another. 

#Content intended for educational purposes only, and should not be substituted for medical advice from your doctor.

Last reviewed January 2019

Sources: everydayhealth, mayoclinic, stanfordchildrens

Leave a Reply

Your email address will not be published. Required fields are marked *