Talk to your midwife or obstetrician about the options you have for dealing with any pain you have.
Although you can feel pain after an episiotomy, it is unusual for this to last for more than 2 weeks.
Paracetamol tablets can really help with the pain and are safe to take. The usual recommended dose is two 500 mg tablets taken every 6 hours. This is safe to take when you are breastfeeding.
Diclofenac tablets or suppositories are also effective painkillers. The suppository is given in your back passage. It is longer-acting and given every 18 hours. Your midwife will show you how to use the suppository.
Aspirin is not recommended as it can be passed onto your baby through your breast milk.
Your obstetrician may prescribe pain relief for you while you recover on the post-natal ward.
When you get home, if paracetamol and diclofenac are not helping your pain, talk to your midwife or GP. They may need to check you in case the area has become infected.
Signs of infection:
- yellow or green discharge
- a lot of redness
- very sore or tender
Make sure to tell them if you are breastfeeding as some medications are not suitable to take when breastfeeding.
Other tips to help deal with the pain
Rest and lie on your side as much as you can.
Place an icepack or ice wrapped in a towel on the wound. Do this for 20 to 30 minutes at a time a few times a day. Leave at least an hour’s break between ice packs. In the first 3 days, especially, using icepacks can really reduce the swelling and inflammation around the wound.
When you are sitting, using a donut-shaped cushion can help you feel more comfortable.
Another tip when sitting is to squeeze your bum cheeks together. This takes some of the pressure off the wound.
Warm baths can help you feel more comfortable as well as giving you a chance to relax.
Some women take 'Arnica'. This herbal remedy is thought to encourage wound healing and reduce bruising. There is no conclusive scientific evidence to prove that it works.
It is normal to bleed for up to 6 weeks after the birth. Never use tampons. Tampons can introduce infection into the area.
Use sanitary pads instead. Change your pads frequently.
Keeping the wound and your perineum clean
Use plain warm water to clean your perineum. Clean it gently and avoid rubbing it. There is no scientific evidence that using witch hazel or salt speeds up wound healing. But if you find them soothing to use, there is no harm in using them.
Wear underwear that is made from a breathable material like cotton. Wear loose comfy clothes. Tight clothes can be uncomfortable while you are healing.
Wash your hands:
- before and after going to the toilet
- before and after cleaning your wound
- changing your pad
This is especially important if there are young children in your home. They might have an infection, such as Group A strep, that you can pass to your wound. This can be very serious if it gets into the blood stream.
Going to the toilet
Wash your perineum after every time you go to the toilet. Pour warm water over your vaginal area after you have been to the toilet. Pouring warm water over your outer vagina as you pee can also help stop the urine stinging.
When you are on the toilet for a pee, lean forward towards your knees. This helps direct your urine away from your wound.
Your first poo
Your bum and back passage can feel a little bruised after the birth of your baby.
It is normal to feel worried about your stitches when you poo. Don’t worry, pooing will not cause your stitches to fall out or your wound to open. There are things you can do to make pooing more comfortable.
Put a clean pad at the side of your wound and press gently as you poo. This can take some of the pressure off the wound.
Gently wipe your bum from front to back. This helps to prevent germs causing a wound infection.
Try not to get constipated. Drink lots of water. Eat foods that are rich in fibre. These include vegetables, fruit, wholegrain oats, wholegrain bread and pasta.
If you find it very painful to poo, talk to your midwife, GP or pharmacist.
Taking a laxative might help. Laxatives are medicines used to treat constipation. Laxatives can soften the poo, making it easier to pass.
Sex after an episiotomy
There are no strict guidelines about when to start having sex again after giving birth. Some experts feel it is a good idea to wait until your bleeding has stopped, to reduce the risk of infection.
Take things at your own pace. It is normal for sex to feel a little different after childbirth.
Remember, it is possible to become pregnant again soon after giving birth. If this is not what you want, talk to your GP about contraception.
Most women find that the first time they have sex after an episiotomy is uncomfortable. If you try to have sex before the episiotomy or any other tears have healed, it can be very painful.
After it has healed, if it is painful at first, don’t worry. This is quite normal. The pain will improve with time. Tell your partner how you feel. If sex is uncomfortable, let them know.
If you are breastfeeding, your vagina may feel drier than usual. This can make sex uncomfortable or even painful. Your sex drive may be lower because of hormonal changes.
Trying different positions can sometimes help reduce the discomfort you feel. You might have to try alternatives to penetration such as oral sex or mutual masturbation for a while.
Have sex at a time when you are not too tired. If you don’t feel like having sex, or you are worried sex is going to hurt, be open with your partner about how you feel.
Pelvic floor exercises
Doing pelvic floor exercises can:
- strengthen the muscles around your vagina and anus
- reduce your risk of having problems controlling your bowel and bladder
- improve the blood flow to this area
- help the wound to heal
- reduce the pressure on your wound and on the skin around your wound