So, you ended up having an episiotomy? We feel for you. No one would choose to have one, but one in seven women do need one. You're bound to be a bit sore down there for a while, but with some TLC, and by keeping an eye on things, you should recover within a few weeks.
Coping with the pain
It's normal to feel pain for two or three weeks after having an episiotomy. It's highly likely that you will have been stitched up using dissolvable stitches (so at least you won't need to have them removed), but even normal things – like sitting and walking – might leave you wincing to start with.
There are some medications, which are safe to use even when breastfeeding, that will help ease the pain.
Paracetamol will probably take the edge off. Be sure to follow the dosage instructions though, and don't take more than is recommended. If your baby was not premature (born before 37 weeks), and did not have a low birth weight, then you could alternatively try the recommended dose of ibuprofen. You must avoid anything stronger than these two, unless you are prescribed a different medicine by your doctor. A small number of women do find the pain very intense, and so may be given a painkiller such as codeine for a short time.
The downside for those mums is that the medicine might interfere with their ability to breastfeed. It's very important that you don't self medicate while breastfeeding without proper advice.
One medication that must always be avoided when breastfeeding is aspirin. It could be passed to your baby through your breast milk, and it might make them susceptible to Reye's Syndrome, which is a rare but potentially fatal illness.
Even with some pain relief, you might still find it difficult to get comfortable when sitting. Some women find that sitting on a rubber ring takes pressure off the cut. OK, you might feel a bit silly, but it could mean you manage to stay sitting upright long enough to eat your lunch!
When you have a moment, you could also try an ice pack. A good old bag of frozen peas, wrapped in a muslin or tea towel can work wonders when held in place for 10 minutes or so. Free up a drawer in the freezer for your ice pack, so you can refreeze it and use again later.
Perhaps you did pelvic floor exercises during pregnancy? Keep them up, because strengthening the muscles around the vaginal wall and anus will help to take the pressure off your cut, and therefore also relieve pain.
Keeping the cut clean
All wounds carry the risk of infection – and being where it is, an episiotomy scar will need to be kept nice and clean.
After having a wee, pour some warm water over your vaginal area (it might be easier to just pop in the shower). Having a wee can sting to begin with, and some women find that pouring water over themselves whilst actually weeing can relieve that sting a bit (it's not the easiest thing to do though).
Doing a poo can also be painful, but more because of the pressure put on your scar when you strain. If this happens, hold a clean maternity pad on your scar and gently push upwards when pooing. Once you're done, always wipe completely clean, and wipe from front to back to avoid passing bacteria towards your scar.
If doing a poo is just too painful, then see your GP – they might prescribe you with a laxative that will make your poo softer, and therefore easier to pass.
How will I know if I get an infection?
You'll almost certainly be aware of it if your cut becomes infected, because the pain will increase, rather than slowly getting better. The pain will be persistent, whatever position you are in – and there will probably be other signs, too.
If the area around your cut is very red and swollen, if there is pus or liquid leaking from the scar, then go to your doctor as soon as possible. They'll take a look and probably offer antibiotics.
Some women develop scar tissue around their cut, which can be uncomfortable because the skin becomes raised and itchy.
If this happens, speak to your GP. In some cases, scar tissue can be removed later on with a minor operation. This won't be done until at least six months after giving birth, however, as the tissue needs time to heal properly first.
But in the vast majority of cases you will heal quickly, and (believe us) having your newborn baby is worth it.
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