Pregnancy, Low C-Section, and Episiotomy Doctor Questions and Answers
Learn more about pregnancy, low-c-section, and episiotomy. Dr. Michelle Trandai, MD, specializes in OBGYN services for women during their pregnancy and post-pregnancy. For more information, call us today or visit us online to book an appointment.
Table of Contents:
What is the difference between C-sections and episiotomy?
Can you have a natural birth after an episiotomy?
How long does it take to heal from an episiotomy?
How long does it take for a cesarean to heal internally?
A C-section is very different than an episiotomy. An episiotomy is a surgical tactic used during vaginal childbirth to allow for a larger opening for the baby to pass through when needed. A cesarean, or C-section, is classified as a major surgical procedure performed on the lower abdomen when a vaginal birth is not feasible for any number of reasons. A C-section will allow the obstetrician to deliver the baby through the mother’s abdomen by cutting through the skin, muscles, and tissues to the womb and lifting the baby out.
Recovery from a C-section is extensive, with the new mom being limited to her activities for the first several weeks after having her baby. An episiotomy is a surgical cut performed to the perineum, which is the soft muscle area between the vagina and anus. By making an incision through this area, the vaginal opening is enlarged to allow the baby to pass through for vaginal childbirth. While still a surgical procedure, it has a significantly shorter recovery time than a C-section.
In most cases, yes: natural childbirth could still be possible on subsequent pregnancies after an episiotomy. Your obstetrician will be able to provide you with details about your specific situation based on how your labor and delivery went, and how mild or severe your episiotomy was. With healing time for an episiotomy being only four to six weeks for a full recovery, many women go on to have smooth, natural childbirth the next time around. During your pregnancy, talk through all of your options with your doctor to understand what factors can determine if you will need an episiotomy. Even in cases of third- and fourth-degree episiotomies, women are often able to have a natural birth with minimal complications.
Healing time from an episiotomy will vary based on the type and size of the incision that was made. There are four different degrees of episiotomy, used to classify the extent of the cut that will also help determine how long it will take your body to heal. A first-degree episiotomy only affects the lining of the vagina and doesn’t impact the underlying tissues at all. A second-degree episiotomy is the most commonly performed incision that cuts through the vaginal tissue in addition to the vaginal lining. It does not reach as far down as the anal sphincter or rectal lining though.
Women will typically feel pain for 2-3 weeks following their delivery for a first- or second-degree episiotomy. Pain may be experienced and more pronounced while sitting or walking, with urinating causing the incision to sting. Third- and fourth-degree episiotomies will take significantly longer to heal as the incisions are much bigger.
In both cases, the incisions do involve the anal sphincter, with a third-degree episiotomy cutting into part of the anal sphincter as well as the vaginal lining and tissue while a fourth-degree episiotomy involves all three plus the rectal lining. These will cause more pain and discomfort, with recovery lasting longer than the typical four to six weeks for your body to fully heal.
A cesarean, or C-section, is considered to be major abdominal surgery. For that reason, recovery and healing after a C-section can take a significant amount of time, particularly for the internal muscles and tissues that had to be cut. In most cases, a C-section is done through a horizontal incision made across the mother’s abdomen, cutting through the skin, tissues, muscles, and wall of the womb to be able to extract the baby.
In some cases, however, the incision may need to be wider, or an additional vertical incision may be done on the inner tissues and muscles to get the baby based on how it is positioned in the womb. Women who undergo a C-section are typically kept in the hospital for three to four days post-delivery to ensure there are no complications. Recovery will typically take about six weeks, provided you are gentle with your body and avoiding too much movement. Easier said than done with a newborn baby.
Dr. Michelle Trandai, MD, may be able to tell you when it is safe to resume low-impact activities such as walking and give you a timeline for more strenuous activities. Remember always, your body has undergone major abdominal surgery and care must be taken when easing back into any activity.
If you feel moderate to severe pain, it is best to discontinue the activity and consult with your doctor to determine if the pain is normal. If you have any questions or concerns, then reach out to Dr. Michelle Trandai, MD, today. We serve patients from Chicago IL, Evanston IL, Ravenswood IL, Uptown IL, Lake View IL, Lincoln Park IL, Buena Park IL, Bowmanville IL, Boystown IL, and Roscoe Village, IL.