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Robert Wool, MD

How Long to Heal From Episiotomy?

How long does it take to heal from an episiotomy?

Episotomy is a term that strikes fear into every pregnant woman’s heart. But an episiotomy, as scary as it sounds, doesn’t have to mean weeks of painful recovery. This surgical incision into the perineum (the tissue between the opening to the vagina and the anus) was once regularly prescribed as a way to help prevent more extensive vaginal tearing during childbirth. But more recently studies have shown that a routine episiotomy does not heal any faster than a natural tear, and in fact the surgical incision is sometimes more invasive and extensive. It can also lead to infection, fecal incontinence and pain during sex.

That said, there are some cases where episiotomies are done, including if your baby is in an abnormal position, if she needs to be delivered quickly or if it appears likely that there will be extensive vaginal tearing. There are also different degrees of tears or lacerations, classified through degrees of 1 to 4.

A first-degree tear is usually just through the vaginal mucous, and will heal in a day or two.

A second-degree tear involves both the mucosa and submucosa (a deeper layer of tissue), which will typically heal in a week or two.

Third- and fourth-degree
A third-degree tear involves the muscle near the rectal sphincter; a fourth-degree tear goes straight through to the rectum. With both of these stages, recovery may last up to six weeks or longer.

The good news it’s fairly uncommon for a doctor to perform an episiotomy, and even if you tear naturally, the vast majority are still either first- or second-degree lacerations, which will heal relatively quickly.

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