Episitomy Basics

In this post we will discuss Episiotomies and how to take care of them once you go home!

An Episiotomy is an incision, or cut, made in the area between the vagina and rectum. This is done during the second stage of labor to make the birth canal bigger.

Reasons this is done include:

  • Prevent damage to your vaginal area from tearing as the baby is born. This can occur if the baby is larger than the vagina can stretch.
  • If forceps or a vacuum are needed to deliver your baby quicker
  • If your baby has a slow heart rate or needs extra oxygen
  • To speed up labor and allow baby be born faster

 

Process: 

  • Close or during the pushing phase of labor, your OB will make a cut/incision with a scalpel or scissors.
  • Once the baby is born, the OB will stitch the incision shut. This is done like any stitches are with a needle and thread.
  • The sutures will take anywhere from a few minutes up to an hour to repair, depending on the extent of the damage.
  • These stitches will dissolve into your skin over time as the incision heals.

 

Pain Control: 

  • In the hospital, you will be given many different things to help control pain caused by this incision. This includes the following:
    • Tylenol and Motrin are the most commonly used pain medications after birth
    • Oxycodone is also frequently used when pain is worse and Tylenol and Motrin cannot fix it completely.
    • Numbing sprays can be used for further discomfort
    • Pads, called Tucks pads, can also be used to help prevent the incision from rubbing on pads or underwear
    • Sitz baths

Sitz Bath: A sitz bath is something given to you in the hospital that looks like a bowl with an IV bag attached. Ours at Sinai is pink.

How to use one:

  • Place bowl in the toilet with the toilet seat up (front and back are labeled)
  • Fill bowl with warm water up to holes in the front and back
  • Clamp the bag tubing and fill the bag with water.
  • Find a place to hang the bag from
  • Sit on the toilet with the toilet seat up so you are sitting directly on the bowl
  • Stick the end of the tubing from the bag in the front of the bowl and toward the middle of the bowl.
  • Release the clamp on the tubing

You will feel the warm water then swirl around, rinsing your incision. This helps keep the stitches clean and helps with discomfort.

  • When done, empty the water into the toilet, clean off the bowl, dry and set aside for next use.
  • Pat yourself dry- do NOT rub dry, this will cause pain.
  • Numbing sprays can now be applied

 

Complications: 

  • Pain
  • Infection
  • Difficulty or pain upon urination/bowel movements
  • Bladder leaks

 

Other Care at Home Tips: 

  • Wound care in general- Sitz baths along with rinsing in the shower with gentle soap and patting dry
  • Kegel exercises: tightening the relaxing the muscles around your vagina can help make the muscles stronger, prevent pain and urine leaks.
  • Avoid sexual intercourse for unto 6 weeks or until your OB clears you (lubrication can help prevent pain)
  • Don’t use tampons for up to 6 weeks, make sure to change frequently

 

Contact A Caregiver/Your Doctor If: 

  • You are leaking urine or BMs
  • You have a hard, painful lump on, or near, your wound.
  • You have bright red blood coming from the incision
  • Your pain does not go away or gets worse
  • The skin between your vagina and rectum is swollen, warm, or red.
  • You are having trouble urinating
  • You have pus or other drainage coming from the wound
  • Your stitches come lose or the wound breaks open

 

Make sure if you have any questions to contact your doctor and feel free to email me with any specific questions.

 

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s