An episiotomy is a cut to the perineum made by a doctor or midwife (with your consent) to widen the vaginal opening during the birth of your baby. It could be advised during a normal birth if there are concerns about your baby’s heartrate, requiring your baby to be delivered quickly, or if you need an instrumental delivery, such as forceps, to help prevent a tear that could damage your back passage. It is a surgical cut and will need to be repaired with stitches.
The healing process for an episiotomy can be from a few weeks to several months, depending on individual circumstances which can include your own health, the size of the cut that was made or whether an infection develops. Tears tend to heal better and more quickly than episiotomies but, again, can be affected by individual circumstances.
Once your scar has completed the healing process it can still feel tender or slightly painful to touch, so you need to decide when you feel comfortable to start trying to massage it. As scar tissue tends to develop quite slowly, massaging the area regularly helps to loosen the tissues as they form so they feel less rigid and tight, and can also help them to form in a flatter shape. Releasing the amount of tightness in the scar tissue can also increase elasticity in the perineum, which can be beneficial if your scar is causing you discomfort. This can help if sex is feeling uncomfortable and may be beneficial in helping the scar stretch more easily during future births.
How to massage episiotomy scar or scar tissue from a tear
You can begin gentle massage after your 6 week check-up, or sooner if the scar is considered well healed. Initially, the scar may be quite tender, red, and painful and it may be best to work around the actual scar itself. As the scar becomes less tender, you can follow this procedure with your fingers directly on top of the scar:
- You may want to have a warm bath or shower first as this can help you relax and soften the area. Find a time when you are unlikely to be disturbed and try relaxing on the bed or a comfy place where you have easy access to the scar area.
- First, massage the skin gently around the scar with the oil.
- Place your fingertips lightly on the skin and start by working the tissues around the scar.
- Use your fingers to move your skin up and down, side to side, and also in little circles.
- Discomfort is okay but it shouldn’t be painful. Take note of how it feels and be conscious about trying to relax.
- If you find a stiff or tight zone, maintain your hold there and breathe – you may feel a release or the tissues relaxing.
When to massage
This is a guide to the frequency of massaging. Everyone is different, though, so develop a routine that feels comfortable for you.
- Once you are ready to start, in the first few weeks after the birth, aim to massage the area for 5 minutes daily until you feel that the tightness around your scar is reducing and you are more comfortable. This may take a few weeks, or longer - everyone is different.
- Then, reduce to a weekly massage, noticing any stiff or tight areas and working with them.
- After this, you may want to simply massage the area every so often - maybe monthly.
- Routine scar massage can be beneficial up until the 2-year mark from the birth of your baby.
- If you find the tissues getting tight again, slip back into a more regular weekly pattern of massaging.