Pain of the episiotomy scar

The episiotomy itself usually causes the mother hardly noticeable pain. This is because anaesthetics are injected into the perineal area before an episiotomy is performed prematurely, whereas with an episiotomy during the birth process the pelvic floor is already stretched so much that its sensitivity to pain is reduced to a large extent. Major complaints, especially pain, are caused by the episiotomy during the healing process after birth.

These are completely normal in the first days and weeks and should only be a cause for concern if they do not significantly decrease or even increase over a period of at least one week. In these cases, the doctor or midwife should be informed of the symptoms in the area of the perineal scar at the follow-up examination. It often takes up to two to three months until the episiotomy scar is completely painless.

During sexual intercourse pain can even occur up to a year after birth, which in extreme cases can even prevent intercourse completely. In these cases, it is advisable to consult a specialist again, who can, if necessary, carry out another small procedure to correct the adhesions in the area of the perineal scar. For the self-therapy of the pain of an episiotomy scar, the usual pain and inflammation-relieving drugs such as ibuprofen or ASS (Aspirin) are initially a proven remedy. In addition, various home remedies are also an effective treatment option, such as cooling the episiotomy scar with cooling batteries or short sitz baths with beneficial essences. It is also advisable to spend as little time as possible in a sitting position and to keep the seam as dry as possible.

Itchy episiotomy scar

If an episiotomy scar itches, this is surprisingly a good sign in most cases. It signals a progressive healing process and a loosening of the stitches. However, an itching episiotomy scar can also be a sign of inflammation.

Therefore, if the itching persists, a specialist or midwife should be consulted who can examine whether the itching is due to an inflammation and, if so, assess the need for certain measures. The same applies to itching which only develops after the stitches have been removed. Since the itching here can no longer signal that the stitches have come off, it is all the more likely that an inflammation has developed which requires medical advice and treatment.

Stigma

Following an episiotomy, there is often a hardening of the tissue around the episiotomy scar. In addition, superfluous scar tissue, a so-called keloid, can be formed. Although these developments are harmless and very common, they often cause great discomfort for the woman, such as a foreign body sensation in the genital area or pain when sitting or during sexual intercourse.

To counteract the hardening, the affected person can massage the hardened episiotomy scar 1-2 times a day with special massage oils. In this case, however, it is recommended to choose the massage oil in the pharmacy if possible and after consulting the doctor or pharmacist in order to avoid incompatibilities in the area of the vaginal mucosa or also the wound suture. In addition, one or two short sitz baths per day with chamomile or oak bark extract are also advisable to soften the hardened perineal scar.

However, these sitz baths should not last longer than 5 minutes each time to prevent excessive softening of the episiotomy scar. If the hardened episiotomy scar causes discomfort when sitting, special seat cushions (such as haemorrhoid cushions) can be used to relieve the area of the episiotomy scar. If no significant progress in the treatment of the hardened episiotomy scar can be achieved even after several months, a surgical suture correction can be performed by the gynaecologist if necessary.