How to Handle... Caring for An Episiotomy
Three takes on helping your body heal after an episiotomy
Doctors sometimes perform episiotomies—incisions in the area between the vagina and anus—just before delivery. They do so to speed the birth process, or to prevent spontaneous tearing. Although the subject is of some debate (are episiotomies really necessary? Helpful? Harmful?), they’re still relatively common. If you’ve had one, you know they add a little extra “ouch” to the postpartum period, and come with special handling instructions in the healing phase. We asked a mom who’s had an episiotomy, a birth expert, and a team of obstetricians for the down-low on how to handle caring for a cut “down there.”
George Mussalli, MD, maternal fetal medicine specialist, and Jaqueline Worth, MD, obstetrician, at Village Obstetrics & Gynecology in New York City
“The pain from a tear or cut (episiotomy) at the opening of the vagina during childbirth is feared by many; the good news is, with a little pampering, the healing can be rapid and manageable. The themes of this kind of healing are warmth, rest, nutrition, pain relief and strengthening.
We suggest the following to our patients:
- Soak in a tub with warm salty water for ten minutes, twice a day, for two weeks. Make the water salty like the ocean. Use fine grain sea salt from the health food store
- Eat lots of protein so your body can heal
- Sleep when the baby sleeps so you have energy
- Ask your doctor for pain medicine appropriate to your needs
- Last of all, find a pelvic floor physical therapist to give you some simple exercises. This step is often forgotten in America but is very popular in France for restoring pelvic muscle tone after a baby.
With a little time and attention to the problem you will soon feel good again!”
Rebecca Woolf, blogger, Girl’s Gone Child
“[My] episiotomy experience taught me about the value of planning, and of finding good doctors —lessons I later put to use when my daughters were born—but healing physically simply required time, and a few essential tools. I was given a healing spray at the hospital that helped a ton with the pain. It had a numbing effect, and I literally cried when I ran out of it, later, at home. (I wish I knew what that stuff was!) I also asked a nurse for a million pairs of mesh hospital undies, put those on ice via an Ace bandage, and cruised around like that—yep, wearing ice-packed mesh panties—for the better part of two weeks.
I was also sent home with a basic spray bottle to keep the stitches extra clean while everything healed. It wasn’t the same as the numbing spray, but it did the job, and I did recover.”
Erica Lyon, author The Big Book of Birth, parent educator and host of Birth 360
“For some women, the physical and emotional recovery is fairly straightforward. A mother who trusted her provider and felt that there was a legitimate reason for episiotomy for the baby’s well-being may have an easier recovery. Feelings of justification for what happens impact how a mom feels about an episiotomy.
In situations where a mom may doubt that her episiotomy was necessary, with no indications of fetal distress, a mom may have an emotional hurdle of healing to work through. Feelings of injury and betrayal while vulnerable can impact her healing process. I have also had fathers who are deeply disturbed by a feeling that they were unable to protect their wives in that moment of episiotomy.
Ultimately, the primary way to deal with episiotomy is prevention. Choosing skilled and experienced providers (OB’s, midwives and family doctors) that deliver babies with deep respect for the body of the woman who is nurturing and birthing the baby is important. How we eat, how we choose our provider, build trust with our provider and the position we push in can all impact whether we have an episiotomy.”
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