How to Care for Your Episiotomy Stitches

Tips for Keeping the Wound Clean and Free of Infection

Parents with newborn at hospital

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An episiotomy is a surgical incision in the perineum (the area between the vagina and anus) made just before delivery to enlarge the vaginal opening. After the baby is delivered, stitches will be used to close the incision or any tears that occur accidentally during delivery. Caring for these stitches is important as it helps minimize the risk of pain and infection during the postpartum healing process.

What Are Episiotomy Stitches?

After an episiotomy is performed, the doctor or midwife will repair the perineum (the area between the anus and vulva) by stitching the wound closed.

Practitioners almost always use dissolvable sutures (also known as absorbable sutures) for an episiotomy. It generally takes a week or two for the stitches to fully break down.

You don't have to return to the hospital to have them removed, and there are rarely any complications associated with their use.

The stitches are typically black but may come in other colors. They will usually begin to dissolve within a few days, which you will notice when you wipe yourself. When you do, there will be little black specks left behind. This is perfectly normal.

Tips for Caring for Your Episiotomy Stitches

Once you return home from the hospital, you will likely feel tender around the perineum. There may be a persistent pain or throbbing, or you may feel an occasional tug or jab. You can often reduce this discomfort by using a covered ice pack for the first day or so, especially if the wound is still swollen and red. Since the skin in this area is sensitive, some prefer soaking a large sanitary napkin in witch hazel, freezing it, then applying it to their underwear.

You will definitely want to keep your perineum clean. You can do this by using a squirt bottle filled with warm water every time you use the bathroom. Pat the area dry rather than wiping to prevent tugging the stitches.

Other helpful tips:

  • Use baby wipes instead of toilet paper, if possible.
  • Always wipe front to back.
  • Use an antibacterial sanitizer on your hands prior to cleaning the perineal area to prevent infecting the wound with your hand.
  • Change your pad every two to four hours.
  • Buy a shallow mini-tub called a sitz bath which fits over the toilet seat and allows you to soak the stitches for cleansing and pain relief.
  • If you have problems drying the wound, you can use a blow dryer set on low; hold it at least 8 inches away from your skin.
  • Over-the-counter pain relievers like Motrin (ibuprofen) can help alleviate discomfort.
  • Cooling medicated pads marketed for hemorrhoid use may also provide relief. Choose one that is hypoallergenic, pH balanced, and perfume-free.
  • Numbing sprays specifically made for new mothers can also be found at most drugstores. Lidocaine gels may also help.
  • Avoid tampons for the first six weeks after your baby is born.

You will typically have your stitches checked at your six-week postpartum visit. At that time, your practitioner will be able to tell you when you can resume sexual relations and offer tips on how to deal with incontinence or any other problem you may be experiencing.

You may also be advised about Kegel exercises to help restore muscle tone around the perineum.

When to Seek Professional Help

As with all surgical procedures, infection is possible following an episiotomy. Do not hesitate to call your doctor if you experience any of the following postpartum symptoms:

  • Severe pain at the incision site
  • Redness and swelling around the stitches
  • Visible pus in or around the wound
  • Fever of 100 degrees F or more

If your doctor is not available, go to the nearest emergency room without delay.

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Article Sources

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  1. Episiotomy - aftercare. Medline Plus. US National Library of Medicine.

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