Episiotomy: why it is done, how the stitches heal and when to call
In this article
An episiotomy is a small cut in your perineum, the area between your vagina and anus, made just before your baby's head is born. It widens the opening when your baby needs to come out quickly, when forceps or vacuum are used, or when a bad tear looks likely. The area is numbed first, and the cut is closed afterwards with dissolvable stitches.
| Where | The perineum, usually cut to one side |
|---|---|
| Numbing | Local anaesthetic, or an epidural top-up |
| Stitches | Dissolvable; no need to have them removed |
| Pain | Usually about 2 to 3 days, KKH says |
| Healed | By about 6 weeks, KKH says |
Why your doctor might do an episiotomy
The NHS says an episiotomy may be done if your baby is in distress and needs to be born quickly, if forceps or a vacuum cup are needed, or if there is a risk of a tear reaching the anus. SGH says it may be done as the baby's head stretches the perineum, known as crowning, to reduce the risk of uncontrolled tearing.
KKH doctors, writing on HealthXchange, say first-time mothers are more likely to need one because the skin there is less stretchy. A tear can run in many directions and a ragged tear is harder to repair, so a cut is sometimes the neater choice. The Royal College of Obstetricians and Gynaecologists (RCOG) says an episiotomy is done with your consent, and the NHS says your doctor or midwife will discuss it with you.
Episiotomy or a natural tear
Some damage to the perineum is common. The RCOG says up to 9 in 10 first-time mothers who have a vaginal birth get some kind of tear, graze or episiotomy. First-degree tears affect only the skin and usually heal without treatment. Second-degree tears go into the muscle and usually need stitches.
Deeper third and fourth-degree tears, which reach the muscle that controls the anus, happen in about 3.5 in 100 women and are repaired in an operating theatre. Preventing these is one reason an episiotomy is offered during forceps births, the NHS says.
How episiotomy stitches heal
KKH says the pain usually lasts about 2 to 3 days, healing is complete by about 6 weeks after delivery, and the stitches dissolve on their own. Passing urine and stools will not affect the cut, but keep the area as clean as you can. Ice packs, stool softeners and pain relief are given if you need them.
The NHS suggests a few things that help at home: an ice pack wrapped in a towel, pouring warm water over the area as you pee, and wiping gently from front to back. It says pain that goes on for more than 2 to 3 weeks is unusual and worth seeing a doctor about. The NHS also says pelvic floor exercises reduce pressure on the cut and help it heal. Our episiotomy guide covers the first weeks in more detail.
Signs of infection to call about
The NHS asks you to call your doctor or midwife if the stitches get more painful, there is a smelly discharge, or the skin around the cut turns red and swollen. In a KKH FAQ on SingHealth, the doctors say an episiotomy wound can break down, usually because infection slowed healing.
In Singapore, call the hospital where you delivered. KKH's 24-hour Urgent O&G Centre takes walk-in patients with post-pregnancy problems. Bleeding after birth is normal for a few weeks, as lochia, but SGH asks you to tell your nurse or doctor about heavy bleeding.
Frequently asked questions
How long do episiotomy stitches take to heal?
KKH says healing is complete by about 6 weeks after delivery, and the pain usually eases after 2 to 3 days. The NHS says the stitches should heal within a month.
Can I say no to an episiotomy?
The RCOG says episiotomies are done with your consent, and the NHS says your doctor or midwife will discuss it with you first. Talk about it with your gynae before labour so you know their approach.
Does an episiotomy cost extra in Singapore?
MOH bills a vaginal delivery with or without an episiotomy repair under one procedure code, SI836U. Its median bill was $1,350 in a subsidised B2 ward as read on 9 November 2026, before MediSave and insurance.
When can I have sex after an episiotomy?
The NHS says there are no fixed rules. Pain during sex is very common in the first few months after a tear or episiotomy, so wait until you feel ready and say so if it hurts.
Related terms
- Perineum: The skin and muscle between the vagina and anus, which stretches in birth and can tear or be cut.
- Pelvic Floor: The hammock of muscles holding up your womb, bladder and bowel, which pregnancy and birth can weaken.
- Lochia: The bleeding and discharge after birth, red at first and paler over three to eight weeks.
- Epidural: Labour pain relief given through a fine tube in your lower back by an anaesthetist, numbing the womb and birth canal.
- 6-Week Postnatal Review: Your own check-up with a doctor four to six weeks after birth, covering healing, mood, feeding and contraception.
- NHS - Episiotomy and perineal tears (read 9 November 2026)
- KKH via HealthXchange - Pregnancy Week 36: Your Baby is About 2.5kg and A Small Note on Episiotomy (read 9 November 2026)
- RCOG - Perineal tears during childbirth (read 9 November 2026)
- SGH - Going into Labour (read 9 November 2026)
- SingHealth (KKH) - Pregnancy Labour and Delivery (read 9 November 2026)
- KKH - Urgent O&G Centre (read 9 November 2026)
- MOH - SI836U: Uterus, Pregnancy, Vaginal Delivery (With Or Without Episiotomy Repair) (read 9 November 2026)
