Discomfort after episiotomy

[Flipjango]

I had a breech vaginal delivery 7 weeks ago which in the main went very smoothly. However, in order to deliver the head it was apparently necessary to give me an episiotomy. It doesn't run down the middle, but off to one side. Anyway, I had some problems with healing as the stitches started to gape. It was extremely painful as it healed and I went back to see doctors several times who told me it would heal eventually, but as the wound had gaped, it would mean the scar tissue would just take longer to 'fill up' the wound. By week 5 everything was fully healed in that it no longer hurt and the wound certainly appeared to have stopped healing (no redness or open appearance). But ever since I've had this uncomfortable sensation, a bit like a tampon falling out (sorry if that is TMI but there really is no other way to describe it). At my 6 week check, the doctor commented that 'they should have put a few more stitches in or have stitched you a bit tighter' as apparently some of the vaginal wall is showing on the outside, and that I should make sure to do my pelvic floor exercises. Anyway, I've had a look with a mirror and it looks as though the wound has healed with the surface slightly open, and as the doctor says, some of my insides are showing on the outside. I don't think I have a prolapse as i have no problems with continence and it doesn't hurt exactly, but it is quite uncomfortable, or unpleasant at least. I've searched and searched online and can't really find anything about this, so was wondering if anyone else has had a similar recovery from an epi, and if so, does it get better, or did you need further stitches/surgical repair to completely close up the original wound? I don't want to keep trailing back to the doctor if this is just going to take time and will eventually heal, but don't want to live with it if it won't. I don't really find my doctor that easy to talk to about stuff like this, so would rather go back well informed if necessary. Thanks!

I don't have any experience but I would go back to the doctor and get a referral to a gynaecologist they will be able to help you, it certainly doesn't sound right. Hope you get it sorted

Get a second opinion. I found the doctor at my local family planning clinic very helpful and obviously more experienced than the gp

Hi Flip - do get a referal to a gynaecologist. You clearly haven't healed as you should. I'm not an expert, but did have a gaping perineum after my stitches failed. Was told it would probably heal naturally - it didn't. The tissue started granulating and I ended up needing corrective surgery 4 months later, after a series of cauterisations didn't work. Your GP probably doesn't see that many post-episiotomy perineums in the course of a normal day, but a gynae will have! Hth.

I echo what all the ladies before me have said. I had an episiotomy for DD1 which fortunately healed well with no longer term issues so I have no personal experience speak of to help you, per se.

However, a friend of mine had a severe tear (tore upwards to he clitoris :( ) She didn't heal well and was referred to a gynae who performed a 'Fentons Procedure'. Basically. She was cut again theatre and sewn back together properly.

I don't know if this is something that would be recommended to you, but I thought it might be useful for you to know.

All the best x

Hi guys

I went to the doctor and asked to be referred to a specialist. The doctor told me she spoke to the hospital and they will not see me until 6 months postpartum. I'm so uncomfortable and as far as I can see, the wound has now fully healed so I can't see why I have to wait for so long- especially as I know what the NHS is like. I could get referred at 6 months, have to wait another few months for an appointment, and then wait another 6 months for treatment. Am I being unreasonable pushing harder to be seen, or should I consider going private (I can afford private consultation, though not sure I could afford private treatment, especially if it was surgical, which worries me. Is there any point in going private if I can't follow through with the whole process?), or do you think I should just wait it out for the 6 months recommended? Does anyone have any knowledge or experience of postpartum healing? Is this 6 month period just the NHS's way of getting rid of people, or is there something in it?

Thanks

Were you given any reason why you had to wait until 6 months? I was seen by a specialist within 6 weeks of referral by my gp and thought that was a long wait (did have a wide open wound though)! As you are in pain I don't think it would be unreasonable to ask your doctor to write to the hospital stating that you need to be seen asap - doesn't sound like your gp put across any sense of urgency. If you still have no joy and you can afford it then seeing a private gynaecologist will at least inform you as at what is going on and whether there is any further treatment that can help you, or if you are just experiencing a very uncomfortable healing process. You really do need a proper examination by someone who knows what they are looking at. In my case that was an internal and an ultrasound.

This may be irrelevant but the specialist I saw said that breastfeeding can sometimes slow down the healing process due to the changes in oestrogen levels, so if you are bf that may be a factor - not that i'd suggest for a minute that you should stop (i'm still going 18 months on).