Content

• Steps
• Advice
• Warning

An episiotomy is a procedure that cuts a short cut in the perineum, the area between the anus and genitals. This surgery is performed on pregnant women to help push the baby out more easily during delivery. The bottom of the pot is often moist and closed, so it can easily lead to infection or slow healing of the wound. However, you only need to follow a few simple methods to reduce the risk of infection, discomfort and pain.

Steps

Method 1 of 3: How to relieve pain

1. 

   Ask your doctor about any pain relievers you can use. Many medications are not suitable for nursing mothers because they pass into breast milk, so ask your doctor for safe pain relievers after the procedure.
   • Paracetamol is usually prescribed for women who are breastfeeding and need pain relief after episiotomy.

2. 

   
   
   Place an ice pack on the perineum while you are resting. Applying cold compresses after surgery can help reduce swelling and pain. Wrap an ice pack in a towel before placing it between your legs while lying flat on a bed or recliner.
   • Do not apply the compress for more than 15 minutes at a time, and stop for a while so that your skin is not too cold.

3. 

   
   
   Squeeze your butt while sitting. Tightening the buttocks helps the tissue to cluster in the perineum, avoiding the suture from stretching or stretching.
   • Sitting on pillows or mattresses can also reduce the pressure and pain in the perineum.

4. 

   
   
   Ask your doctor about a sitz bath. Depending on your actual situation, your doctor will advise you whether to use a sitz bath daily or not. A sitz bath helps relieve pain, swelling, and bruising around the wound.
   • Fill the tub with warm or cool water. Warm water helps to increase blood circulation so you should feel comfortable, but cool water reduces pain faster.
   • Sit in the tub for about 20 minutes.

5. 

   Spray the sutures with water while you are urinating as urination can be painful in the incision. In addition, urine sticking to the incision will create conditions for new bacteria to enter it.
   • To reduce discomfort and keep the stitches clean, you should spray water on it with a hose while urinating, continue to spray water for a while after urinating to wash the wound.

6. 

   Apply pressure to the wound while defecating. Defecation is really a difficult problem after women undergo perineal incision. To solve this problem, press a clean tampon against the perineum while pressing, this will reduce pain and discomfort.
   • Throw away the tampon after using it and use a new pad each time.

7. 

   Reduce the risk of constipation. Constipation puts more pressure on the episiotomy during defecation, because the incision is stretched and painful when squeezed. To reduce your risk of constipation, drink plenty of fluids, eat fiber-rich foods, and exercise lightly throughout the day.
   • Drink at least 8 cups (250 ml) of water a day if you are breastfeeding and more if you are breastfeeding. Do not be reluctant to drink too much water because excess water also causes loss of breast milk, just not letting yourself be thirsty.
   • Eat foods rich in fiber. High-fiber foods soften stools and make it easier for you to have a bowel movement, and fruits and vegetables are good examples.
   • Do light exercise during the day. Exercise promotes more movement of your colon to push food down, you should do light exercise for 15-30 minutes per day in the postpartum period.
   • Let your doctor know if you are constipated. If any of the above solutions still can't improve your constipation after a few days, your doctor may prescribe a stool softener until your body is back to normal function. Do not take your own constipation medicine before consulting your doctor.
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Method 2 of 3: Support the wound healing process

1. 

   Keep the operating area dry and clean to promote healing. Since the wound is between the vagina and anus, you must take extra care to keep the area as dry and clean as possible.
   • Always flush the wound with water after urinating and clean the anus from before to after defecating. This cleaning method keeps the perineum clean and reduces the risk of fecal contamination.

2. 

   Do a Kegel exercise. Start doing Kegel exercises as soon as possible after giving birth if your doctor says so. Kegel exercises help improve blood circulation and speed wound healing, in addition to work to restore cell damage after birth.
   • Kegel exercises tone the pelvic floor muscles, the muscles that support the bladder, uterus, and rectum. In addition to assisting in the healing process of an episiotomy, exercise also improves urinary incontinence in women and enhances muscle spasm during orgasm.
   • Practice after you urinate and imagine yourself trying to hold your pee and deflate at the same time, meaning you have to squeeze and lift the muscles that control the urination. Be sure not to use any other muscle while squeezing and lifting the urinary control muscle. Do not tighten abdominal muscles, squeeze legs together, pinch buttocks or hold your breath. This way, you can only use the pelvic floor muscles while exercising.

3. 

   Allow the wound to breathe. Since the perineal incision is not exposed to much air during daily activities, you need to allow the wound to air from time to time, the time it takes to expose the incision to the air is a few hours a day.
   • During nap or night sleep you may not be able to put on your underwear to expose the wound to more air.

4. 

   Change tampons after 2-4 hours. You will need to wear a tampon while you wait for the wound to heal. The tampon keeps the stitches dry and prevents blood from sticking to your underwear, and the dry and clean environment also helps the wound heal faster.
   • Remember to change the tampon every two to four hours even though it looks clean.

5. 

   Consult your doctor about sexual intercourse and use of tampons. Perineal incision usually heals in 10 days, but the internal structures have dilated and there may be very small internal lacerations. Most doctors recommend waiting 6-7 weeks after giving birth before having sex again.
   • Talk to your doctor before starting sexual activity to make sure it's safe.

6. 

   Watch out for wound infection. Infections cause the wound to heal slowly and cause more pain. If an infection does occur, get treated right away to prevent further complications. During the first 7-10 days after surgery you must observe the stitches and surrounding area every day. Let your doctor know if you experience any of the following:
   • Pain gets worse
   • The wound seemed to come loose
   • Bad discharge
   • There is a stiff or painful lump in this area
   • The skin between the vagina and anus is redder than usual
   • The skin between the vagina and anus is swollen
   • Pus oozing from the stitches
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Method 3 of 3: Understand and prevent the possibility of having an episiotomy

1. 

   Understand the purpose of episiotomy during childbirth. During natural birth, the baby's head must slide through the vagina to leave the mother's body, at which point the baby's head will press against the perineum until the tissue in this area expands wide enough to be able to slip over. Your doctor will perform an episiotomy if:
   • The fetus is large and needs more space to get out
   • Baby's shoulders were stuck during birth
   • Labor is so fast that the perineum doesn't have time to dilate before giving birth
   • The fetal heart rate shows that the baby is having problems and needs to be born as quickly as possible.
   • The fetus is in an abnormal position

2. 

   Learn about the perineal incision surgery. Doctors usually perform one of the two types of episiotomy and both require the same care after delivery and after discharge. Deciding which incision type will depend on your body composition, the amount of space needed for your baby to come out and the rate at which your baby is born.
   • They made a single incision from the end of the vagina to the point between the anus and vagina, which is the easiest incision for the doctor to sew after giving birth, but there is a risk of ripping through the anus during delivery.
   • The second way of surgery is to make an incision from the end of the vagina to an angle far away from the anus, this surgery prevents the risk of splitting to the anus but causes more pain after birth. It is also difficult for the doctor to sew this incision after that.

3. 

   Tell your doctor about your concerns. Make it clear that your desire is to allow enough time for the perineum to dilate during delivery, and ask them to advise you on how to avoid having an episiotomy.
   • Make sure your wishes are recorded in the prenatal plan for the hospital staff to follow. You should plan this in the office with your doctor or during your first admission.
   • During labor use a warm compress pressed against the perineum to make it easier for tissue to relax during delivery.
   • Ask your doctor if you can stand or squat to push, as this puts more pressure on and helps the perineum relax more easily.
   • In the first stage, you should push lightly for 5-7 seconds while breathing steadily to slow down the birth process and spend more time for the baby's head to press against the perineum, allowing the perineum to expand.
   • Have your doctor press gently on the perineum so it doesn't tear.

4. 

   Do a Kegel exercise to avoid having an episiotomy. You can reduce the risk of having an episiotomy by doing Kegel exercises during pregnancy, toning the pelvic floor muscles and making sure you are ready before delivery.
   • Spend 5-10 minutes a day doing Kegel exercises.

5. 

   Massage the perineum area. About 6-8 weeks before giving birth, you should massage the perineum once a day, this will reduce the chance of tearing or having to incision the epis. You can do it yourself or ask your partner for help.
   • Lie on your back with your head resting on several pillows, while arching your knees.
   • Apply a small amount of essential oil to the skin of the perineum, use plant-based oil or coconut oil to soften the skin tissue to help it stretch better.
   • Place your finger about 5 centimeters in the vagina and press down toward the anus. Move your finger in a U-shape so that the skin between the vagina and anus relaxes. You often feel hot or throbbing pain.
   • Keep the stretch for 30-60 seconds and then release, each massage you should stretch the perineum skin 2-3 times.
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Advice

• Remember, it takes about 10 days for an episiotomy to heal, but in some cases it may take a month. Try to be patient while taking care of the wound.
• Care must be taken to keep the incision clean and dry, to reduce the risk of infection and speed healing.
• Consult with your doctor about the reasons for having an episiotomy and how often they perform the procedure. There are times when an operation is really needed, but it is certainly not a regular procedure.

Warning

• Contact your doctor right away if pus is draining from the wound, if the suture is coming out, or you have a fever.