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Childbirth

Share experiences and get support around labour, birth and recovery.

Original poster

In agony after episiotomy

27 replies

Daffodil87 · 07/04/2021 23:07

Hello - hope someone can help. I gave birth 2 weeks ago and had to have an episiotomy with forceps delivery. I was discharged from the hospital the next day and just told to take some ibuprofen for the pain if needed. A day or so after getting home I have been in agony and barely able to walk or sit. I've been taking short lavender and tea tree oil baths and some with Epsom salts too. I lie on a towel to air the stitches out after the baths. I've been washing after each time I go to the loo too. I've also had 4 midwives check the stitches for me and all of them have said that the stitches look "good" and aren't infected but just swollen. Each midwife gave different advice on pain relief though. I am now taking a combination of ibuprofen and paracetamol at regular intervals .
The pain seems to be getting worse though and is now unbearable and I am sick of crying every day and all the conflicting advice I am getting from the midwives.
Can someone advise me on the following n2 questions please:

  • I am taking 2 paracetamol every 4 hours and 2 ibuprofen every 8 hours. When I take the 2 ibuprofen I take them together with 2 paracetamol (so 4 tablets at once). This is based on the latest advice from the midwife. The pain relief doesn't last long though! GP has advised me that because I am breastfeeding there is nothing else stronger that they can prescribe me.
  • I bought some Emla cream from the pharmacy to numb the area and haven't used it yet. I did see someone mention on one of these threads that this shouldn't be used though. Any ideas why??

Thanks.

OP posts:
Original poster
Daffodil87 · 07/04/2021 23:09

Sorry re the first question I just wanted to know if my pain relief schedule looks ok or if any of you have taken these tablets more regularly like every 2 hours.

OP posts:
AnnaSW1 · 07/04/2021 23:13

I'd get better pain relief from your gp. They will prescribe it for you.

In the meantime have 2 paracetamol then two hrs later have 2 ibuprofen and alternate like that. It's better like that.

Didiusfalco · 07/04/2021 23:14

You’ve almost certainly got an infection. Get to the doctor or A&E you need antibiotics but also someone to check the wound hasn’t reopened and needs a repair (I had a repair op for this reason.) Lay off the tea tree and lavender, soaking a wound and adding oils to it is not recommended by gynaecologists.

Didiusfalco · 07/04/2021 23:15

By the way I don’t think you would be crying with pain if there wasn’t an underlying infection.

AnnaSW1 · 07/04/2021 23:16

I don't agree it's almost certainly an infection. It can just be very painful if it was a deep cut and can simply need stronger analgesia.

SunnyAfternoonInWinter · 07/04/2021 23:18

You need antibiotics. Go back to the hospital/GP. Also take painkillers every 3 hours. I couldn't walk for a MONTH after my episiotomy until I was given antibiotics.

BrioLover · 07/04/2021 23:20

That sounds horrendous. Mine were very painful too but that was due to an infection. I'd call the maternity ward rather than the GP and see if they'll take a look at you. Otherwise urgent care.

All you should need after two weeks is the occasional painkiller. I'd recommend lukewarm plain baths every few hours, being naked as much as possible to prevent the wound getting hot/moist/damp, and lots of water so you keep weeing. Also a jug of water to pour over your vulva as you wee, it helps.

Didiusfalco · 07/04/2021 23:20

Well either way the op shouldn’t be crying in pain and it shouldn’t be getting worse so she needs medical attention

PinkSparklyUnicorn · 07/04/2021 23:23

This may sound really stupid but... like you I had an episiotomy and the pain was unbearable, I could not sit properly, could not walk properly... midwife had a look and it looked "good" but yet the pain was still there. In the end, another midwife had a look and noticed that a hair was caught in one of the stitches, meaning that everytime I moved or placed myself in a certain position, that hair got pulled and pulled the whole thing stitches: it was agony! She managed to snip it and no jokes, I cried big tears of relief of being pain free.

So, check it's not a stupid hair and if it is not, I would agree with the others, get it check at your GP!

Good luck xx

thisismadness77 · 07/04/2021 23:23

I was the same, it was worse than the birth. Like you, a few midwives glanced and said it looked ok. Eventually at my 8 week check the doctor agreed it looked red, and cauterised it. I thought that meant she was going to take a flame to it, but the reality was that she dabbed at it with a magic silver topped stick. It was almost instantly better.

user1471530109 · 07/04/2021 23:25

Mine weren't infected and it was the most painful thing for bloody weeks! I had a C-section the next time and it wasn't a patch on the episotomy.

I read on here at the time over a decade ago to freeze a sanitary towel and put it between two paid of knickers and wear it. It was lovely. You can also buy ice packs for this v purpose from boots Flowers
Congrats and it does get better I promise.

Larsingsong · 07/04/2021 23:26

So sorry op. It's been 12yrs since my episiotomy and a haven't forgotten the pain and recovery 😔.

I had the midwife and gp check because of the pain, they released a couple of stitches. Other than that I think it was best to refrain from any oils/additives to the bath (against initial advice).

It did heal without trouble after a while by itself, it was just very painful to sit or stand for long.

Hope you feel better soon.

Bagelsandbrie · 07/04/2021 23:26

Please seek medical attention and ask for stronger pain relief. Something like strong Cocodamol 30/500 would be better than what you have now.

I had a huge episiotomy after the birth of my dd (now aged 17 but I remember it well!) and it was SO painful. I was still in pain with it 8 weeks on and ended up seeing a consultant who said I had a lot of internal keloid scarring and that’s what was making it all worse. They did offer to re stitch me but I couldn’t face that again so left it and eventually it did settle down. I actually opted for an elective c section due to the pain and the traumatic birth I’d suffered leading up to it and my c section was wonderful - much less painful!

Definitely ask for help. Go higher than the midwives - ring 111 and say you’re not coping with the pain if necessary.

Bagelsandbrie · 07/04/2021 23:27
  • a c section for my second child. Sorry somehow missed that bit!!
Larsingsong · 07/04/2021 23:30

I also had an emergency c section first time, and the episiotomy was equal if not worse recovery!

I didn't get diagnosed with an infection, but it was so so painful for a number of weeks. It'll be better in time op.

maryberryslayers · 07/04/2021 23:30

You can take dihydrocodeine whilst breastfeeding, I'm on it following my c-section and had it after my first birth too. Just ask doc to prescribe.

tankflyboss · 07/04/2021 23:35

This happened to me too. It was absolutely horrible. I did turn a corner on about day 12. I would keep getting them checked for infection and hopefully this will pass soon enough xxx

Babyfg · 07/04/2021 23:56

I agree with pp it does sound like an infection. I had one with mine and it was awful. One of the midwifes recommended a bath with six drops of tea tree oil and two cups of milk. It wasn't a magical cure but it did help a little bit.

tinylittleyou · 08/04/2021 00:05

Mine was years ago but it was absolute agony for a few weeks, no infection though. I was prescribed some stronger painkillers. Hope you’re feeling better soon Flowers

AnnaSW1 · 08/04/2021 00:08

@Didiusfalco I agree as that's what o said on my post

Breadtoastbread · 08/04/2021 04:04

Hi OP, sorry you are going through this.

Breastfeeding can make people anxious about prescribing but you need to control the pain better imo to aid recovery. My last tear was 2nd degree and the recovery slow.

I suggest politely direct GP towards:
www.breastfeedingnetwork.org.uk/analgesics/

I presume their hesitancy is in codeine which is not recommended but not a complete contraindication

Could you discuss them prescribing a short course of diclofenac?

(Basically stronger ibuprofen)

I would also ask for the wound to be swabbed and a for them to consider giving you a prescription for antibiotics (I had co amoxiclav) either to take now if there is ANY concern of infection or to have ready for when swab results come back to take if needed.

I would be quite firm ask are they 100 percent there is no infection? Because if there is any chance say you want the antibiotics.

infection is the biggest cause of breakdown / pain of wound and that will massively impact on your long term recovery

Good luck keep us updated

PurpleTygrrr · 08/04/2021 08:45

Ah love I've been there, episiotomy pain is awful. I had Diclofenic prescribed and took that regularly for about 3-4 weeks alternating with paracetamol. Also used spritz for bits on it and on my pads which was lovely and soothing.
Hope it gets better for you soon! X

Cinnamama · 08/04/2021 10:52

I had episiotomy and 3rd degree tear and it was very painful. In hospital I had ibuprofen, paracetamol and tramadol. When discharged dropped to paracetamol and ibuprofen. About 2 weeks after I remember thinking it was getting more painful and driving me mad but the midwife said that was because it was healing. However I had already had a course of antibiotics (because of 3rd degree tear) so definitely push for investigation for infection. I was on 400mg ibuprofen at 7am, 3pm 11pm. And 1000mg paracetamol at 10.30am, 3pm, 7pm and 11pm. I felt much better from around 6 weeks on so I hope you feel better soon too.

MeadowHay · 08/04/2021 18:52

I disagree this is definitely an infection, mine wasn't infected and I had awful pain. Definitely make an appointment with your GP or midwife to have it checked again ASAP. Also definitely see your GP and demand stronger pain killers. It's an absolute disgrace that so many birthing and postnatal women are not able to access adequate pain relief. I made a big fuss about my episiotomy pain in hospital so they discharged me with diclofenac, I think it was a two week course but may hace been more. I took that with paracetamol alternating and it was still very painful, I struggled to walk far or squat down to the floor much for the first 3 weeks or so. Once the diclofenac was done I took alternating ibuprofen and paracetamol for another week or two and gradually reduced these as needed.

If pain has suddenly increased though this could be a sign of infection or part of the wound reopening. Mine healed nicely apart from the pain and by week 5 or 6 I was not aware of pain much anymore and discharged by the community midwifery team. Unfortunately around this time literally a day after discharge I rolled over in bed and faced a terrible sharp pain at the episiotomy site and suddenly had ongoing pain and mobility difficulties again. GP examined me and a tiny part of my wound had opened, it was so tiny that he didn't think it worth the ordeal of a restitch so I was advised OTC pain relief and regular applications of Sudocrem which I got DH to do. It healed quickly but it was emotionally distressing to have my recovery go backwards again for a bit after all the pain I had initially suffered.

sausagerollcake · 08/04/2021 18:58

800mg of ibuprofen per dose but it needs to be prescribed, when I had my first that's what they gave me.

With my second I was in agony, I couldn't sit and yet they told me it all looked good. Having looked the other day, they were lying.

I found an ice pack helped x