Types of Episiotomy and how to heal from it

What are episiotomy and the types of episiotomy you should know?

If you are nearing your due date and have planned vaginal delivery, apart from the labor pains,  you must also prepare yourself for Episiotomy.

What is Episiotomy

In simple terms, Episiotomy is a surgical incision or a cut that is made in the perineum—the tissues between the vaginal opening and the anus—that allows for a smoother delivery. There are various degrees of incisions (from one to four) based on the progression of the childbirth.

An episiotomy cut was once a routine part of vaginal delivery. But now, it is only done if needed; that is, only if the vaginal passage of the delivering mom is too small for the baby to come out.

Why is Episiotomy done?

Gynecologist may recommend episiotomy stitches in the following cases:

• There is an extensive vaginal tear where the vaginal wall appears to tear as the baby comes out
• Your growing baby is coming out in an abnormal position
• You’re giving birth to a baby that is too large to pass through your vaginal passage
• The baby is distressed and needs to be brought out quickly

In such cases, if you are to be administered an Episiotomy, you may receive local anesthesia. Once you are on it, you will not be able to feel the tear or the stitches post delivery.

Episiotomies are rare. Thus your doctor is unlikely to recommend one unless it is very necessary. Talk to your doctor in advance about your concerns and if you want to avoid getting an Episiotomy cut.

Types of Episiotomy

Again, depending on the baby’s position or natural tear of the vagina, the mom in labor can be given two types of Episiotomy.

• Median or midline Episiotomy cut: This type of incision is given vertically and could be small (extending from the vaginal opening to right above the anus). Although this type of incision is easy to repair, it has the risk of extending to the anus.
• Mediolateral Episiotomy stitches: This type of incision is made at an angle. It is made all the way to the anus, may take longer to repair and heal, and is also painful in many cases.

Episiotomy Degree

Healthcare practitioners classify episiotomy according to the severity of the tear using levels, much like perineal tears (or degrees). The degrees of episiotomy range from:

• 1st-degree is a little tear that solely impacts the lining of the vagina.
• A 2nd-degree cut is when your vaginal lining is penetrated to the underlying vaginal tissue. Episiotomies in the second degree are typical.
• A 3rd-degree Episiotomy cut is one that compromises the tissues and lining of the vagina as well as the anal sphincter.
• 4th-degree: The tear has an effect on the rectum, anal sphincter, vaginal lining, and vaginal tissues. the most problematic and serious kind of tear.

The advantage of an Episiotomy cut (of both types) is that it may prevent a natural vaginal tear. But now, how long do you have to wait for an Episiotomy healing?

How quickly will an Episiotomy repair?

If you are administered an Episiotomy or have a vaginal tear during delivery, depending on your health and care post delivery, it might take a few weeks to have an Episiotomy repair. It may even hurt for a few weeks, especially sitting or walking. And if the tear or incision is extensive, it may take more than four weeks.

It is noted, however, that stitches administered in an Episiotomy are dissolvable and absorb into the body as they heal.

How to relieve Episiotomy pain

To relieve pain or discomfort from any types of Episiotomy:

• Ask your nurse to apply cold packs after the birth. Using ice lowers swelling and relieves pain in the first 24 hours after delivery.
• After giving delivery, you should wait 24 hours before having a warm bath. Make sure the bathtub has been cleaned and disinfected before each bath.
• Take ibuprofen or another medication to reduce discomfort.
• Use stool softeners and drink lots of water. As a result, constipation will be prevented. Diets high in fiber will also be advantageous. 

5 natural ways: how to heal Episiotomy fast

It is always advisable to take natural precautions on how to heal Episiotomy fast. You can try the following for starters and consult your specialist about them.

• Cold compress: You can soothe the wound using a cold compress. Place the ice pack on the sanitary napkin, or you can even insert chilled (doctor recommended) pads that can be placed between the wound and your sanitary napkin.
• Episiotomy Healing: Warm water therapy: The incision may make it quite uncomfortable for you to pass the urine. It may even sting. So to take the sting out of the urination process, you can put warm water while peeing and gently dry it with a warm cloth.
• Careful bowel movements: While sitting for your bowel movements, place a clean warm or cold pad over the wound. Do not put too much pressure on your tummy because it can aggregate the pain and/or force a stitch out.
• How to heal Episiotomy fast? Say no to soaps: More often than not, soaps can aggregate the pain, act as an irritant, and may add to pain in the perineum. So use plain warm water. It is enough to keep the area clean.
• Opt for a sitz bath: This works wonders for aching vaginal tears and incisions. Doctors recommend sitting in a tub of warm water with a few drops of disinfectant at least twice a day after a vaginal delivery. This not only disinfects but also soothes the pain around the area.

Always consult your doctor about Episiotomy when you discuss your birth plan.

What happens if Episiotomy doesn’t heal

The following are possible problems from an episiotomy:

• Bleeding
• Infection
• Painful intercourse
• Rectus and anal sphincter injuries
• Scarring
• Urinary incontinence
• Longer period of recovery

If you have had an episiotomy and you have experienced any of the following, call your doctor immediately:

• Pain doesn’t get any better.
• A nasty discharge or pus is oozing from the incision.
• The skin around the Episiotomy cut looks swollen or red.
• Your wound is gushing blood.
• You experience physical discomfort, cold, or heat.

How to avoid Episiotomy

All types of episiotomy are challenging to prevent because so much of it is outside your control. 

Many medical doctors suggest expanding your perineum when pregnant to help prevent ripping. Massaging your perineal tissue (the area between the vaginal entrance and anus) in the weeks leading up to delivery may reduce your chance of tearing or needing an episiotomy cut. Although stretching the perineum is generally safe, there is conflicting evidence that it has any therapeutic benefit.

Another way to reduce having episiotomy stitches is to apply a warm compress to your perineum during the second stage of labor. As a result, the tissue might become more elastic. 

The best thing to do how to avoid Episiotomy: Talk to your healthcare provider about perineal massage or other techniques to reduce tearing during labor.

Republished with permission from theIndusparent

Additional information from Margaux Dolores

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