Caring for Your Episiotomy Stitches

Care Tips and When They Should Dissolve

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If you have episiotomy stitches after your baby is born, or if you had stitches after a tear, you will want to know how to care for them. This helps you minimize any pain or discomfort you may have from them. By planning ahead, you can also have specific medications or items on hand to help prepare for the postpartum period.

Episiotomy Stitches

The type of stitching done can have an effect on the amount of pain that you feel after you have a baby.

Your doctor or midwife will repair the perineum and the surrounding area with a variety of possible techniques, though continuous suturing (stitching) techniques tend to produce a reduction in pain for the length of the entire postpartum period. You can ask what type of sutures you have before you leave the hospital

The materials used by your doctor or midwife for the stitches typically dissolve on their own. This means that as you heal, the material breaks down and disappears. This can take a few weeks before it happens, so you might have even forgotten about it at first.

If you were to look at your perineum, you may notice small black stitches. A few days after you get the stitches, you may notice that there are small pieces of the black suture material on your toilet paper when you wipe. That's a sign that they are dissolving. This is not a problem.

How to Care for Your Episiotomy Stitches

Chances are you're feeling a bit tender in the area from your vagina to your rectum, called the perineum.

This whole area expanded to allow the birth of the baby and slowly goes back into shape. These tissues may be swollen and ice packs right after birth can be very beneficial.

You will not necessarily need to provide any special care for the stitches (also known as sutures), other than keeping your perineum clean.

Usually, you will want to use a squirt bottle, called a peri bottle, with warm water after you use the bathroom and pat dry.

You can also choose to place cooled TUCKS® pads on your sanitary napkin to soothe the tissues. This is beneficial even if you don't have any stitches.

If you're having a problem keeping the perineum dry, you can use a hair dryer set on no heat or low to gently dry your bottom. Some practitioners also recommend a heat lamp between your legs. Also remembering to pat dry instead of wiping will help.

Medications and Pain Relief

You are more likely to have pain if a vacuum extractor or forceps was used your tissues may have sustained more damage. There are medications that you can use to increase your comfort. Medications can range from over-the-counter products to oral medications prescribed by your doctor, depending on the extent of your pain. Do not hesitate to ask if any pain medication was ordered for you. You should take it only as prescribed. Most women find that oral pain medication isn't needed after the first few days. There are some over-the-counter topical sprays that cool and make the area numb. 

Some doctors and nurses also suggest a sitz bath, this is a warm, shallow mini tub that is usually fit over a toilet seat that allows water to run over the stitches for pain relief and cleansing.

This can be done at the hospital or at home. Some companies even sell herbal sitz bath products for promotion of healing and comfort.

Sometimes you can also use topical ointments, creams or things in your sitz bath to aid in healing and soothing. You can also try doing certain exercises right after giving birth.

When to See Your Doctor

Infection is possible in this sensitive area. Be sure to call your doctor or midwife immediately if you have:

  • Severe pain
  • Redness around the stitches
  • Fever of 100.1 F or higher

Rarely, you may need to have your stitches redone or removed. They may also be able to recommend other treatments or pain relief medications, particularly if you had an extensive repair done.

Follow-Up Care After Stitches

You will have your stitches checked by your doctor, midwife, or a nurse at your six-week postpartum visit. It is part of the comprehensive health exam to make sure that you're recovering after giving birth. Your practitioner can answer questions you have about the area, including when you can resume a sexual relationship and how to do so without pain. 

Sources:

Gabbe SG. Obstetrics: Normal and Problem Pregnancies. Philadelphia, PA: Elsevier; 2017.

Kettle C, Dowswell T, Ismail KM. Continuous and interrupted suturing techniques for repair of episiotomy or second-degree tears. Cochrane Database of Systematic Reviews. 2012. doi:10.1002/14651858.cd000947.pub3.

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