An episiotomy is a surgical incision made in the area between the vagina and anus (perineum). It is used to enlarge the vaginal opening before delivery. After the baby is delivered, stitches are used to close the incision as well as repair any tears.

Most episiotomies heal in about 3 weeks, though it may take longer for some. Proper care of the stitches minimizes infection risks and helps manage pain.

What Is Perineal Wound Dehiscence?

Sometimes, stitches can break down due to infection or pressure, leaving a gaping wound—this is called perineal wound dehiscence.

Signs of Wound Breakdown

• Increased pain
• New bleeding or pus-like discharge
• Feeling unwell
• Stitch material falling away

What to Do If You Suspect Wound Breakdown

• See a healthcare professional immediately.
• They may examine the stitches and check for infection.
• A swab may be taken for diagnosis.
• A short course of antibiotics is usually given.
• Anti-inflammatory pain relief like ibuprofen is helpful and safe while breastfeeding.
• Severe cases may require hospital admission and IV antibiotics.

Will They Stitch It Back?

• If infection is present, re-stitching is avoided to prevent trapping infection.
• Once the infection clears, re-stitching may be done if necessary.

Healing After Wound Breakdown

New tissue gradually fills the gap. Healing speed depends on wound size, depth, and infection duration. A red scar may appear initially, which fades with time.

Ways to Aid Healing

• Keep the area clean and dry—use only water at first.
• Let the area air dry; avoid rubbing with a towel.
• Avoid using soaps, oils, or creams on the wound.
• Change sanitary pads regularly.
• Consider going without underwear at night for better airflow.

Tips to Prevent Wound Breakdown

• Eat a healthy, fiber-rich diet to avoid constipation.
• Stay hydrated.
• Support your stitches when laughing, sneezing, or coughing.
• Avoid lifting heavy loads or strenuous activity.
• Do things gently and gradually.
• Don’t smoke or drink.

Note: Experiencing wound breakdown once does not increase the risk for future vaginal births.