Help Needed -- Struggling with Episiotomy (3Rd or 4Th Degree)

Updated on March 28, 2010
J.D. asks from Jersey City, NJ
26 answers

My wife delivered our 2nd son two days' ago. Our first was a C-section - she didn't dilate enough even after laboring for 8 hours. We were keen on VBAC & went for a doctor who was pro-VBAC. She had another long labor this (8am - 5:30pm) time; the dr. was willing to wait for the labor to proceed; not sure if he rushed once the baby was close to being delivered; the baby was 7lb. 15oz; he kept saying that it's a big baby and proceeded with epi; I heard the nurses say it was an "extension" & saying "is it better to have c-section or extension". Seems like it could be 3rd/4th degree.. Can't bear to see my wife suffering...Looking at past postings, seems like she is in for a horrible 6-8 weeks, possibly longer. The dr. just mentioned that it'd heal...Nurses at the hospital said that this is normal...

What can we do to make the healing go faster? From past postings, seems like

a) lots of water to reduce acidic urine
b) witch hazel pads; some suggest putting them in the freezer (or just the fridge?)
c) she uses the squirt bottle
d) she's using the dermplast as well
e) one posting suggested blow drying after a shower. does that work?
f) Does Epifoam help? Is it like Dermplast?
g) She's started the sitz bath. But with water only. Are there any medications that could be added to the sitz bath?

Is there any other suggestions?

At this stage, I'm not sure if I'm going to get a sympathetic session with our obgyn. Is there a midwife or epi-specialist whom my we can see to help her? She is biting her lip & suffering silently! We're in the Jersey City, NJ area.

Thanks in advance for your replies/suggestions.

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So What Happened?

THANK YOU SO MUCH!!! Your replies & your experiences reassure me (a bit!) that the healing will happen eventually. Reading your descriptions of all that you've endured gives me a new perspective of women go through. So, where are we now.. She's taking Motrin 400 once every 6 hours. We stopped the Percocet due to concern about how it might affect the baby. Also, she's taking her antibiotics to head-off any infections. She's using the boppy pillow when sitting; she's doing the sitz bath regularly (once every 5-6 hours). She was concerned about adding epsom/chamomile or other herbs without consulting the dr.. We've paged him & will call his office tomorrow. She's resting now but her milk flow isn't much & that's amother source for our anxiety. Babies R US doens't seem to have the Earth Mama Bottom Balm that has been highly recommended by all. I'll have to order that online. Thankfully, the new one is drinking his milk & going to sleep regularly without raising a ruckus & that's been a big source of comfort.

Featured Answers



answers from Boise on

have you tried epsom salts and sea salt in the sitz bath? epsom salts are magnesium. I have read online that applying magnsium chloride to pain (like arthritis) takes away the pain instantly. look it up online.
The other thing you can look up is sweedish bitters. There seems to be lots of things online about how that can heal- even old scars, if you keep applying it over and over.

1 mom found this helpful


answers from Kansas City on

for the sitz bath, my doctor recommended going to the pet store and getting the salt for salt water aquariums, it was called Instant Ocean. She had me do this because it mixes better with the water. I didnt have an epi, but I did have a lot of tearing and this did help with pain.



answers from New York on

First, her labor was not long. I know you must have thought so, but it
really is the norm. The first week or so it will be uncomfortable (remembe
it has only been 2 days). Had they not done the episiotomy and she
tore herself apart, it would be a big problem. So be patient, keep doing
what you are doing and time will heal. Congratulations.

More Answers


answers from Los Angeles on

Hi am sorry to hear that you wife is going threw this. When I had my daughter I tore form the doctor vaccuming my daughter out and also had to be cut down there. Know one told me how bad I would hurt. I hurt to get out of bed, walk, or even sit down. I like in a 2 story house so coming down the stairs was a nighmare. What worked for me was using the water bottle with warm water and I got so desperate that I used neosporin with pain relief ointment and that seem to help.

1 mom found this helpful


answers from New York on

i have to say i dont like the sound of this doc giving an epi on your wife.
That wasnt such a long labor - i had a 28 hour labor! with a midwife and she was against epi cause they lead to such bad tears. so she let me tear naturally on my own and then cut the tear on a diagonal to make sure it didnt go far. All the methods for healing you mentioned are good. Also what my midwife had me use is tons of aloe vera gel. she said slather it on and use blow dryer on low setting. I did this for at least a month. helps skin heal. It tok me 3 months to heal as my baby was 9.4lbs. a 7.15 isnt that big and that is why I would never use a doctor...saying that is big and deciding to do an epi. Midwives allow the woman to labor natural and allow for a long labor. sometimes our bodies need to labor for dont alllow that.
Good luck to your wife healing. I know it is painful but she will heal!

1 mom found this helpful


answers from San Francisco on

The HERBAL SITZ BATH from Whole Foods are a gift from god. They look like teas bags and you put them in warm water and sit twice a day. They are amazing.

1 mom found this helpful


answers from New York on

Hello J.D.:

I am a Natural Therapy Practitioner in the maternity field and have assisted women with such conditions. As a suggestion, add 3 drops of Lavender Essential Oil and 2 drops of Chamomile Essential Oils in a bowl of cold water and bathe the area at least 3 times per day. This will help with inflammation and pain management.

Another recommendation is Reflexology. There are nerve points on the feet and hands that connect to the entire body, including the reproductive system. By administering a special technique to these points, there will be stress reduction and trauma healing in the reproductive system.

If you have further questions, please feel free to call me directly.

All the best and congratulations on the birth of your baby!

Holistic Healthcare Practitioner



answers from Detroit on

Sitz baths (nurse told me no additives - just the hottest water I could stand) several times a day, sitting on a foam donut after clinching while getting up and down, ice packs, Motrin 600, Dermaplast and Tucks.

I can't answer about blow drying the area...haven't heard that one.

I think it's great that you are recognizing your wife's pain and taking an active part in ensuring her comfort. You are definitely on the right track. Unfortunately, it does take a lot of time to heal.



answers from New York on

Wow, I can relate. I have three kids and two big episiotomies. I've heard that C sections are easier to recover from. Your poor wife. Suffering in silence is no good. If it's only been two days she may heal up quickly and be fine soon. Some painkiller are fine for nursing mothers. If I didn't have Motrin and Percoset I would never have gotten through it. It's no time to be a hero and refuse meds. Also, if she is not feeling significantly better after a week or so, she should see the doctor. I developed infections both times and thats what killed me. After I started anti biotics I slowly began to feel better. It's, by far, the worst pain I've ever felt. Worse than labor because there seems to be no end in sight. Even the pain killers only dulled the pain. The best you can do for her is to have her rest as much as possible and pamper her. And make sure she gets plenty of fiber because constipation is a big problem after child birth and that when she has issues in that area already, a painful bowel movement should be avoided. Seriously, a lot of fiber. Sorry for being so graphic, but as a parent, you're probably used to it. I'll be thinking of her and hope she's on the mend soon. The warm sitz baths are helpful if it doesn't hurt too much to sit. The squirty bottle and dermoplast help too. Good luck.



answers from New York on

What about sitting on the inflatable air tube used for hemroids. That helped me so much after the episiotomy. Also, limit stair walking.

We also would open the back of a diaper and stick ice cubes in. THis way it was an ice pack, but the diaper protected from being too cold and absorbed the melting water.

One other thing, take colace or stool softener to help with bowel movements, as those are so painful. The stool softener is a MUST.

One thing that my sister in law did for me that was very helpful was to buy a bunch of high fiber snacks (fiber one granola bars, uncle sam's cereal, high fiber crackers, etc). and put them in every location I sat, like next to the bed couch and nursing chair. This way when I could snack when the baby was nursing and it was on high fiber foods. It was so easy.
Good luck. It is so painful, but it sounds like you are a very supportive husband. That is so helpful and I am sure your wife really appreciates it, even if she is in too much pain and too sleep deprived to tell you. Hang in there, it does pass,and each day will hopefully get better.



answers from Chicago on

donut pillow to sit on if you don't have one. i couldn't survive w/out it.
there's also pain sprays' she can use, ask pharmacist, i know i got it in the hospital. it took forever. that's crazy. doesn't seem like it should of been that huge of a tear for that size baby. mine was over 9 lbs and i think it was 2nd degree. if she has hemroids on top of it tell her icy hot. i read it online here and was scared to try it and it was the ONLY thing that helped.


answers from Jacksonville on

She CAN feed her baby if she is taking a low grade pain med like Tylenol3 or even low dose vicodin. Best thing I did was ask for something. Have her tell her doc she wants a prescription to take home with her. Beyond that, the squirt bottle instead of wiping and the ice packs were the biggest comfort to me. But nothing would have helped without pain meds.



answers from New York on

Hey! Reading your post brings back some awful memories. If you search my past postings, you will see my cry for help
and advice on the same thing in 2007. I too had a 2nd degree tear. My body ejected my daughter out of me and that resulted in me tearing almost all the way near my rectum and up toward the front. I also had an inexperienced resident sew me up. Needless to say, I was in agony. The biggest advice I can give, aside from everything she is already doing which is great, would be to REST. I can't stress this enough. I didn't rest enough and that made healing near impossible. I ended up getting an infection and that was probably the worst thing I have ever experienced. So please let her rest and stay off her feet. And let her know that it will heal with time and it will be a distant memory that is ultimately worth it. Good luck and God bless!



answers from Los Angeles on

My Ob gyn told me to take motrin 600 three times a day to reduce the swelling thats very hard to get of otherwise. I was fine with a week. I had 2nd degree Episiotomy. If the pain is even more severe, change your doc or get a second opinion, your wife does not have to suffer. Intense pain is not acceptable and you HAVE to get the doc to give her something for it. She can be given Percocet or Naproxen or Vicodin or any other prescription med for it. Only thingis she cannot feed the baby while taking these meds. Feeding with motrin is fine though.



answers from New York on

YIkes. I know what that is like. Had a huge epi with my first. I was so traumatized by the entire experience that I had a home birth for baby #2--just a little tearing (sorry if it's tmi). And what someone else mentioned about cutting being better than tearing is the old way of thinking. The current thinking is that it's better to tear naturally (think about a piece of fabric--if it tears, you may get a small rip. If you cut into the fabric, then you have a weak spot, and the fabric will then tear more easily, sometimes further. Sorry again if that's tmi.

My midwife gave me a great herbal remedy that she made for the peri bottle. I can't remember what's in it, but you can buy similar stuff from Earth Mama Angel Baby...

The herbs helped me to heal very quickly. Personally, I couldn't take the sitz bath after my epi, and couldn't even sit "evenly" -- I had to sit to one side or the other.

Good luck, and congrats on the baby!



answers from New York on

When I gave birth and they cut me the healing was about 7 days of of horrid pain and it got better from there. I remember the first day I could barely walk I had to take the baby for his 10 day check up. All the things she is doing keep doing. It will heal. I know I received over 30 stitches. Good luck with the new addition.



answers from Portland on

Try a postpartum doula. They can give support, possibly answers, or ask to see another obgyn. I was given vicodin to take home and lots of the spray. I didn't like the witch hazel pads because I didn't feel like they worked for me. I would scour the internet for postpartem doulas they can point you in the right direction!



answers from Dallas on

Okay - I have had 4 babies now. Had severe episiotomies before. The BEST method I have had is to have your wife continuing taking the medicine she came home on!! Be sure to have her take the pain meds ON TIME, EVERY TIME. They really do help - keep doing this atleast for two weeks!!
Next run to Babies R Us for her. Have her STOP using that dermplast and/or epifoam junk. I used that right after delivery of our baby 4 months ago and I about jumped out of my skin. I washed it off immediately because it stung SO much! Go out to babies r us, have her stay home and have someone direct you to something called Earth Mama Angel Baby. They have TONS of products there. Get the one called Bottom Spray and also the one called Bottom Balm - maybe even get the herbal bath! The dermplast and epifoam went straight into my trash can because those were so painful for me - the Earth Mama Angel Baby stuff is SO SO SO much better. It has NO stinging effects at all and will help her feel SO much better!!!! Please go get this stuff for your wife. This lady even makes stuff for breastfeeding, diaper changes for the baby, etc. If we have any more children I will be bringing all of this stuff with me to the hospital and will REFUSE that dermplast junk!!!!

Yes, keep using the squirt bottle until she is completely healed! Warm baths help - but be sure to help her stand up...she will most likely have weak muscles after the just getting out of the tub is a chore.

Seriously these will help her have a much easier time recovering (the pain meds and the Earth Mama Angel Baby products) U can view them online, but I wouldn't wait for shipping...the pain she is in is surreal, go get them asap for her. This was my 4th baby and having this stuff made a world of difference!! I will definitely be using it if we have any more children and will be telling ALL pregnant women about it - and no, I don't get some kind of kick back for supporting this lady and her products - in fact, wish I had created something like this so I could be rich! ;0) But it really does work that well!!!

And dad - u are doing a good job taking care of her! Even asking for help is a big step. You both are doing great!! How is your little gift doing?

Hope mommy will be feeling better soon!! Please keep us updated with how she is the mean time I wouldn't have her use those other products - for me personally those prolonged my suffering immensely!!



answers from St. Cloud on

You are a fab husband! Kudos to you for being so caring of your wife. My husband was so gentle and supportive and it made my pain much easier to bear. Sounds cheesy, but it's true.

I had a 4th degree episiotomy/tear. It took 3 months to heal. One thing that complicated things was that I had a staph infection at the tear site, compliments of hospital instruments (yay!). If your wife is in serious pain, she should be checked for infection. If they say no, DEMAND it.

She can also add 10 drops of tea tree oil to her cleansing bottle and use it every time she uses the bathroom, showers or bathes. It will prevent infection and help with the pain. I wish I had known about this with my first baby, the second time around it saved me!
I also used the dermaplast and the Earth Mama Angel Baby product that another poster mentioned.

This is fantastic, all this advice! I suffered so much with my first baby from this exact problem! With so many ladies telling their experience, your wife doesn't have to suffer.

Congratulations on your new little one!



answers from Kansas City on

I dealt with this with both of mine my second one was a lot more severe I ended up with a huge hematoma all I could do was put an ice pack down there to numb it and a sitz bath I think I did like 3 a day morning, noon, night. Cudos to you for being so concerned and wanting to help her out!!!



answers from Rochester on

Congrats on your new little one and sorry for all your wife is going thru. I've been in her shoes before and recommend plenty of warm baths (like 5-6 per day!). Do NOT add anything to the bath- will irritate the area! Witch hazel too, while people say works, is also very irritating to any wounds! I ended up seeing a colorectal surgeon (never needed surgery thankfully), but ended up with having tears requiring medical ointment rx. Best of luck and your wife! Hats off to you for supporting her so nicely!



answers from Boston on

I had a 4th degree episiotomy with my first daughter. I had been pushing for 3 hours and wasn't getting anywhere, so it did help, however was very painful after. I think the pain is still not as bad as a c-section and heals quicker. The best thing is to stay off your feet for a while as much as possible (tough with a newborn) and definitely take whatever pain medecine is offered and take regularly. Sitz baths helped a lot too. I think you'll find that she'll be feeling much better within a few weeks, it really does heal on its own down there. By her 6 week checkup she may not have any pain, just some discomfort.

I've also read that many doctors don't do episiotomies anymore, I wish I was given a choice. The doctor I got (not my own) just handed that scalpel to the resident and it was happening before I even realized it. On the other hand, the head just wasn't coming out either, and I still would prefer an epi to a c-section. Its still better than major surgery.



answers from Boston on

Kudos to you for being so supportive. I agree she should keep taking whatever pain meds they gave her. The baby will be fine. ICE! I sat on ice packs for about 2 weeks. It made a world of difference. The tucks pads were also really helpful.

The good news, I think, is that the majority of the recovery is generally better in about 2-3 weeks, rather than 6-8, so while the pain is pretty unbearable at this point, it does get better relatively quickly. And, I know that a poster below said that the doc shouldn't have done an epi, and maybe it shouldn't have been done, but just so you know, tearing is no picnic either, so she shouldn't expend a lot of energy being angry at the doctor.

Finally, suggest that she take colace or some other gentle stool softener. Unless you have the most open relationship ever, she might not want to mention that she's probably terrified to have a bowel movement for fear of pain and/or ripping her stitches. A very high fiber diet is a good plan around now, so she can go with the greatest ease.

Good luck to you both with the little one.



answers from Buffalo on

Congrats on the baby! Your wife just need time to heal. I was in the same situation, It really heals fast.



answers from Dallas on

Another very easy, quick tip is this: Prior to sitting, and I mean on her way down, have her do a kegal and hold it. Or clinch butt cheeks together. Hold until she sits. Man oh man does it help with that pain.



answers from Chicago on

That Dr needs to be disciplined. Since around 2000, scientific evidence has shown that episiotomy are worse than tearing and should not be done.

Sorry I don't have any suggestions. I think soaking in witch hazel might be one thing she can do. I'd do a google search for a midwife page. I can't remember what my midwife told me to soak in....

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