Maternal Health

Episiotomy Recovery and Concerns

Medically reviewed by Dr. Lisa Okafor, MD, FACOG · Board-Certified OB-GYN

Content reviewed against published ACOG, NIH, NICE guidelines

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Your health matters just as much as your baby's. If you are dealing with episiotomy recovery and concerns, here is what you need to know.

The short answer

An episiotomy is a surgical cut made in the perineum (the area between the vagina and anus) during delivery to widen the vaginal opening. While once routine, episiotomies are now performed selectively when medically indicated. Recovery typically takes 2-4 weeks for the initial healing, with full recovery over several months.

Key takeaways

  • An episiotomy is a surgical cut made in the perineum (the area between the vagina and anus) during delivery to widen the vaginal opening. While once routine, episiotomies are now performed selectively when medically indicated. Recovery typically takes 2-4 weeks for the initial healing, with full recovery over several months.
  • Usually normal when: Soreness, swelling, and discomfort at the incision site for the first 2-4 weeks
  • Call your doctor if: Signs of infection: increasing redness, swelling, warmth, pus, or foul-smelling discharge from the site
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What Parents Should Know

According to ACOG, NIH, NICE guidelines, an episiotomy is a surgical cut made in the perineum (the area between the vagina and anus) during delivery to widen the vaginal opening. While once routine, episiotomies are now performed selectively when medically indicated. Recovery typically takes 2-4 weeks for the initial healing, with full recovery over several months. At Labor & delivery, episiotomies are now only recommended when there is a medical need, such as when the baby needs to be delivered quickly or during an assisted delivery with forceps or vacuum. Your provider should discuss this with you if possible before making the cut. A local anesthetic is used, and the cut is repaired with dissolving stitches after delivery. It is generally considered normal when soreness, swelling, and discomfort at the incision site for the first 2-4 weeks. However, you should contact your pediatrician promptly if signs of infection: increasing redness, swelling, warmth, pus, or foul-smelling discharge from the site.

Sources: [1], [2], [3]

Normal vs. Concerning

Usually Normal
Worth Discussing
Soreness, swelling, and discomfort at the incision site for the first 2-4 weeks
Signs of infection: increasing redness, swelling, warmth, pus, or foul-smelling discharge from the site
Mild discomfort when sitting, walking, or having bowel movements
Stitches have opened and the wound is gaping
Gradual improvement day by day
Severe pain uncontrolled by prescribed medications
Stitches dissolving on their own over 2-6 weeks
Fever along with wound pain

By Age

What to expect by age

Labor & delivery

Episiotomies are now only recommended when there is a medical need, such as when the baby needs to be delivered quickly or during an assisted delivery with forceps or vacuum. Your provider should discuss this with you if possible before making the cut. A local anesthetic is used, and the cut is repaired with dissolving stitches after delivery.

Postpartum

Healing from an episiotomy typically takes 2-4 weeks for surface healing, with deeper tissue healing over 2-3 months. Ice packs, sitz baths, peri-bottles (squirting warm water while urinating), and stool softeners can help with comfort. Sitting on a donut cushion and taking pain medication as recommended by your provider can also help. Stitches dissolve on their own.

What to Tell Your Pediatrician

  • Describe when you first noticed episiotomy recovery and concerns and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if pain is not improving after 2-3 weeks or is getting worse.
  • Mention if you have concerns about how the area is healing or how it looks.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

What Should You Do?

When to take action

Probably normal when...
  • Soreness, swelling, and discomfort at the incision site for the first 2-4 weeks
  • Mild discomfort when sitting, walking, or having bowel movements
  • Gradual improvement day by day
  • Stitches dissolving on their own over 2-6 weeks
Mention at your next visit when...
  • Pain is not improving after 2-3 weeks or is getting worse
  • You have concerns about how the area is healing or how it looks
  • Pain during intercourse persists beyond 3-4 months postpartum
Act now when...
  • Signs of infection: increasing redness, swelling, warmth, pus, or foul-smelling discharge from the site
  • Stitches have opened and the wound is gaping
  • Severe pain uncontrolled by prescribed medications
  • Fever along with wound pain

What You Can Do at Home

  • Keep track of when you notice episiotomy recovery and concerns — noting the time of day, duration, and any triggers can help your pediatrician.
  • Remember that soreness, swelling, and discomfort at the incision site for the first 2-4 weeks — this is generally within the range of normal.
  • At Labor & delivery, focus on observation rather than intervention unless your pediatrician advises otherwise.
  • Prioritize your own rest and nutrition. Accept help when offered, and do not hesitate to reach out to your healthcare provider.
  • While monitoring at home, seek immediate care if signs of infection: increasing redness, swelling, warmth, pus, or foul-smelling discharge from the site.

Perineal Healing After Birth

Perineal soreness after vaginal delivery is nearly universal, whether or not you had a tear or episiotomy. Minor tears and episiotomies typically heal within two to three weeks, while more severe tears may take longer. Good perineal care with ice packs, sitz baths, and proper hygiene can significantly ease discomfort and promote healing.

Assisted Delivery (Vacuum or Forceps) Concerns

Assisted delivery using vacuum or forceps is sometimes needed to help guide the baby out when pushing alone is not sufficient. These tools are used by experienced providers and can help avoid a cesarean section. Temporary marks or swelling on the baby's head are common but resolve quickly. Both methods have a strong safety record when performed by skilled providers.

Pain During Sex After Having a Baby

Pain during sex after having a baby is very common and affects the majority of women in the first few months postpartum. It can be caused by vaginal dryness, scar tissue from tears or episiotomy, pelvic floor muscle tension, or hormonal changes. While some discomfort during the first few attempts is expected, persistent pain is not something you need to simply endure and there are effective treatments available.

Guide

Postpartum Recovery Guide

Week-by-week postpartum recovery timeline and warning signs.

Guide

When to Call the Doctor

General guide on when to call the pediatrician, visit urgent care, or go to the ER.

Frequently asked questions

Is episiotomy recovery and concerns normal?
An episiotomy is a surgical cut made in the perineum (the area between the vagina and anus) during delivery to widen the vaginal opening. While once routine, episiotomies are now performed selectively when medically indicated. Recovery typically takes 2-4 weeks for the initial healing, with full recovery over several months.
When should I call the doctor about episiotomy recovery and concerns?
Signs of infection: increasing redness, swelling, warmth, pus, or foul-smelling discharge from the site Stitches have opened and the wound is gaping Severe pain uncontrolled by prescribed medications
When is episiotomy recovery and concerns normal?
Soreness, swelling, and discomfort at the incision site for the first 2-4 weeks Mild discomfort when sitting, walking, or having bowel movements Gradual improvement day by day
What causes episiotomy recovery and concerns?
An episiotomy is a surgical cut made in the perineum (the area between the vagina and anus) during delivery to widen the vaginal opening. While once routine, episiotomies are now performed selectively when medically indicated. Recovery typically takes 2-4 weeks for the initial healing, with full recovery over several months. Common explanations include: Soreness, swelling, and discomfort at the incision site for the first 2-4 weeks. Mild discomfort when sitting, walking, or having bowel movements.
What should I mention to my pediatrician about episiotomy recovery and concerns?
You should mention episiotomy recovery and concerns at your next visit if: Pain is not improving after 2-3 weeks or is getting worse. You have concerns about how the area is healing or how it looks. Pain during intercourse persists beyond 3-4 months postpartum.
Is episiotomy recovery and concerns normal at Labor & delivery?
Episiotomies are now only recommended when there is a medical need, such as when the baby needs to be delivered quickly or during an assisted delivery with forceps or vacuum. Your provider should discuss this with you if possible before making the cut. A local anesthetic is used, and the cut is repaired with dissolving stitches after delivery.
Is episiotomy recovery and concerns normal at Postpartum?
Healing from an episiotomy typically takes 2-4 weeks for surface healing, with deeper tissue healing over 2-3 months. Ice packs, sitz baths, peri-bottles (squirting warm water while urinating), and stool softeners can help with comfort. Sitting on a donut cushion and taking pain medication as recommended by your provider can also help. Stitches dissolve on their own.
Should I go to the ER for episiotomy recovery and concerns?
Seek emergency care if signs of infection: increasing redness, swelling, warmth, pus, or foul-smelling discharge from the site, or if stitches have opened and the wound is gaping. When in doubt, call your pediatrician's after-hours line for guidance.
Does episiotomy recovery and concerns go away on its own?
In many cases, episiotomy recovery and concerns resolves on its own, especially when soreness, swelling, and discomfort at the incision site for the first 2-4 weeks.
ACOGNIHNICE

References

  1. [1]American College of Obstetricians and Gynecologists. Prevention and Management of Obstetric Lacerations at Vaginal Delivery. ACOG Practice Bulletin No. 198, 2018. ACOG
  2. [2]National Library of Medicine. Episiotomy. StatPearls, 2023. NIH
  3. [3]National Institute for Health and Care Excellence. Intrapartum Care. NICE, 2023. NICE

Doctor Visit Checklist

Bring this checklist to your next pediatrician visit to discuss Episiotomy Recovery and Concerns.

Things to mention

  • Describe when you first noticed episiotomy recovery and concerns and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if pain is not improving after 2-3 weeks or is getting worse.
  • Mention if you have concerns about how the area is healing or how it looks.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

Observations to share

  • Pain is not improving after 2-3 weeks or is getting worse
  • You have concerns about how the area is healing or how it looks
  • Pain during intercourse persists beyond 3-4 months postpartum

Urgent signs to report immediately

  • Signs of infection: increasing redness, swelling, warmth, pus, or foul-smelling discharge from the site
  • Stitches have opened and the wound is gaping
  • Severe pain uncontrolled by prescribed medications

My notes

From ismybabyalright.com — free, evidence-based baby health guides

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members

Related Resources

Feeding & Pumping GuideEar Infection TriageMedicine Dosage CalculatorEmergency ContactsBaby Tracker

Bottom line

Most cases of episiotomy recovery and concerns are normal. Talk to your pediatrician if signs of infection: increasing redness, swelling, warmth, pus, or foul-smelling discharge from the site.

Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.

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Perineal Healing After Birth

Perineal soreness after vaginal delivery is nearly universal, whether or not you had a tear or episiotomy. Minor tears and episiotomies typically heal within two to three weeks, while more severe tears may take longer. Good perineal care with ice packs, sitz baths, and proper hygiene can significantly ease discomfort and promote healing.

Assisted Delivery (Vacuum or Forceps) Concerns

Assisted delivery using vacuum or forceps is sometimes needed to help guide the baby out when pushing alone is not sufficient. These tools are used by experienced providers and can help avoid a cesarean section. Temporary marks or swelling on the baby's head are common but resolve quickly. Both methods have a strong safety record when performed by skilled providers.

Pain During Sex After Having a Baby

Pain during sex after having a baby is very common and affects the majority of women in the first few months postpartum. It can be caused by vaginal dryness, scar tissue from tears or episiotomy, pelvic floor muscle tension, or hormonal changes. While some discomfort during the first few attempts is expected, persistent pain is not something you need to simply endure and there are effective treatments available.

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