Prevention and Healing

It’s not uncommon for the perineum to tear during birth. But there are steps you can take to help reduce the
likelihood of this happening.
 
● Pay attention to your position during labour. Different positions may put less pressure on your perineum.
Lying on your side or hands and knees may feel more comfortable.
 
● Have someone provide perineal support. This requires an individual to see the perineum and provide gentle
pressure with warm clothes against the perineum during pushing. This can help control the pressure against
the perineum by the baby’s head during delivery.
 
● Some pregnant individuals choose to practise perineal massage. This type of massage may help to make the
tissue around the vagina more flexible and reduce the chance of experiencing a tear or having an episiotomy.
 

What is an Episiotomy
An episiotomy is a surgical cut in the muscular area between the vagina and the anus (the area called the perineum)
made just before delivery to enlarge your vaginal opening. There is no reason for an episiotomy to be done routinely,
however, an episiotomy may be done:
 
● Where there is a concern with the length of time it is taking for the baby to be delivered and the birth needs to occur
due to baby’s heartrate concerns or other medical concerns.
 
● If a vacuum or forceps are required for the delivery it is common for the Obstetrician to cut an episiotomy.
 
 
Recovery from an Episiotomy or Perineal Tear
If you had an episiotomy or a tear during delivery your midwife will repair it with stiches using a local anesthetic and
dissolvable sutures. If the tear is extensive, the midwife may request that an Obstetrician do the repair. Recovery from
an episiotomy or tear can be uncomfortable or quite painful, depending on how deep and long the tear is. The pain
can affect sitting, walking, urinating, and bowel movements for up to a week after delivery. An episiotomy or tear can
take up to 4-6 weeks to heal fully.
 
To reduce pain and promote healing:

● Use ice packs for pain and swelling
 
● Have regular sitz baths in a tub of warm shallow water
 
● Take ibuprofen (Advil) and acetaminophen (Tylenol) as directed
 
● Drink lots of fluids and increase fibre intake and take stool softeners as required.
 
● Use warm water from a squeeze bottle to keep perineal area clean and pat dry. If you wipe, do so only from front to back.
 
● Do not sit on a “doughnut” or ring-shaped cushion, as this may put pressure on the stitches.
​