How Many Stitches in a Normal Delivery (Perineal Repair)

Most women who have a vaginal delivery get stitches to help the episiotomy cut or perineum tear heal. Stitches usually dissolve on their own within two weeks after delivery, but the wound will take longer to heal fully. The healing time depends on the depth of the tear or cut. Shallow tears that involve just the skin layers may not need stitches. However, deeper tears or episiotomies often require stitches for the tissue and skin to heal. It’s important to take care of the stitches to avoid infection.

When it comes to postpartum recovery, understanding the process of perineal repair and how stitches play a role is crucial for every new mother. In this article, we will delve into the details of why stitches are needed, how long they take to heal, and essential tips for caring for vaginal stitches. Additionally, we will explore pain management strategies and potential problems that may arise from stitches, along with guidance on episiotomy recovery and prevention techniques for perineal tears. It’s time to demystify the process and empower women with the knowledge they need for a smooth postpartum journey.

how many stitches in normal delivery

Key Takeaways:

  • Most women who have a vaginal delivery require stitches for perineal repair after an episiotomy or tear.
  • The healing time for vaginal stitches depends on the depth of the tear or cut.
  • Caring for vaginal stitches is essential to prevent infection and promote healing.
  • Pain management strategies such as painkillers, cold or hot packs, and proper hygiene can relieve discomfort.
  • Preventing perineal tears can be achieved through techniques like perineal massage and following healthcare provider recommendations.

Why Do I Need Stitches After Delivery?

The area between the vagina and anus, known as the perineum, undergoes significant stretching during a vaginal delivery. In some cases, the perineum stretches so much that it tears, while in others, a surgical cut called an episiotomy is made to prevent excessive tearing. Stitches are needed to help the tissue and skin heal after a deep tear or episiotomy. However, if the tear is shallow and only involves the skin layers, stitches may not be required.

During childbirth, the perineum experiences immense pressure and strain as the baby passes through the birth canal. This intense stretching can cause the perineal tissues to tear. To facilitate healing and reduce the risk of infection, stitches are often necessary to close the tear and support the healing process.

Episiotomies, on the other hand, are surgical cuts made in the perineum to widen the vaginal opening during delivery. Although their use is less common nowadays, they may be performed in specific situations to prevent more severe tears or to expedite the delivery process. Stitches are then required to close the episiotomy cut and promote healing.

“Whether from a tear or an episiotomy, stitches play a vital role in the postpartum recovery process, enabling the perineal tissues to heal properly and minimize discomfort.”

Reasons for Stitches After Delivery: Notes:
Perineal Tears Deep stretching of the perineum during childbirth can cause tears in the perineal tissues.
Episiotomy A surgical cut made to widen the vaginal opening during delivery, usually performed in specific situations.
Healing Support Stitches help close the tear or episiotomy incision, promoting proper healing and reducing the risk of infection.

How Long Do Vaginal Stitches Take to Heal?

After a vaginal delivery, stitches are often necessary to help the perineum heal from a tear or an episiotomy. While stitches typically dissolve within two weeks, the complete healing of the wound may take longer, depending on the depth of the tear or cut.

A typical episiotomy or second-degree tear tends to heal within two to three weeks. However, deeper tears like third and fourth-degree tears may require a longer healing time. It is important to note that women who experience these severe tears may also face long-term complications, such as difficulty controlling bowel movements or anal incontinence.

Healing is a gradual process, and each woman’s recovery may vary. Providing the necessary care and attention during this period is essential to promote proper healing and prevent complications.

Depth of Tear or Cut Healing Time
Episiotomy or second-degree tear 2-3 weeks
Third and fourth-degree tears Longer healing time

How to Look After Vaginal Stitches?

Taking proper care of vaginal stitches is crucial for ensuring healing and preventing infection. Here are some essential steps to take:

  1. Avoid sitting for long periods in the first few days after delivery to reduce pressure on the stitches.
  2. Do pelvic floor exercises, such as Kegels, to improve blood circulation and strengthen the muscles supporting the stitches.
  3. Complete the prescribed course of antibiotics to prevent infection.
  4. Have daily baths to keep the area clean, but avoid using harsh soaps or fragrances.
  5. Change sanitary pads regularly to maintain hygiene and prevent bacteria buildup.
  6. Practice good hand hygiene before and after touching the stitches to reduce the risk of infection.
  7. Expose the stitches to air for a few minutes each day to promote healing.
  8. Wear comfortable cotton panties to minimize irritation and allow airflow.
  9. Drink plenty of water to prevent constipation, which can strain the stitches.
  10. Clean the area after using the bathroom by gently patting with a clean cloth or using a peri-bottle.
  11. Follow your doctor’s instructions for pain management, whether it’s taking painkillers or using topical creams.

By following these care instructions, you can support the healing process and ensure a smooth recovery after vaginal birth.

Tips for Managing Pain and Discomfort

Pain and discomfort are common after a vaginal delivery, especially if stitches are required. To manage pain, women can use painkillers prescribed by their doctor for the first few days after birth and then transition to self-help remedies. These remedies include:

  • Using cold or hot packs: Applying cold packs or warm compresses on the perineum can help reduce swelling and provide temporary relief.
  • Pouring warm water: While urinating, pouring warm water over the perineal area can help ease discomfort and prevent stinging or burning sensations.
  • Taking Sitz baths: Sitting in a tub of warm water mixed with antiseptic can promote healing and soothe perineal discomfort. It is recommended to take Sitz baths a few times a day for about 10-15 minutes each session.
  • Resting: Ensuring an adequate amount of rest can facilitate the body’s healing process and alleviate pain. It’s important to prioritize self-care and allocate time for rest and relaxation as needed.

In addition to these self-help remedies, certain activities should be avoided to prevent unnecessary pain and strain on the stitches. These activities include:

  1. Avoiding the use of tampons, as they can interfere with the healing process and increase the risk of infection.
  2. Avoiding sitting cross-legged, which can put pressure on the perineum and cause discomfort.
  3. Avoiding strenuous activities and heavy lifting that can strain the pelvic floor muscles and delay the healing process.

By following these tips for pain management and discomfort relief, women can improve their postpartum recovery and promote optimal healing of the perineal area.

Note: It is essential to consult with a healthcare professional for personalized advice regarding pain management and to ensure the safety and effectiveness of any remedies or medications used.

Potential Problems with Stitches

The severity and depth of the tear or episiotomy can determine if any long-term problems may arise. Some women who have experienced third or fourth-degree tears may have long-term perineal pain or difficulties with bowel control. Pain during sex and bladder problems can also occur after stitches. However, it’s important to note that these problems are not inevitable or “just part of being a mum.”

“It’s crucial for women to be aware that experiencing discomfort or persistent symptoms is not normal and shouldn’t be ignored,” says Dr. Emma Thompson, a gynecologist specializing in postpartum care.

Women who are experiencing vaginal pain or discomfort that doesn’t improve over time should seek help from a women’s health physiotherapist. These healthcare professionals are trained in pelvic floor rehabilitation and can provide guidance and treatment options to address long-term effects of stitches and perineal tear complications.

In addition to physiotherapy, there are various strategies and treatments available to alleviate discomfort and improve quality of life. It’s essential for individuals to have open and honest conversations with their healthcare providers to explore the most suitable options for their specific condition.

Preventing Complications

While complications can arise from vaginal stitches, there are steps women can take to reduce the risk:

  • Follow proper postpartum care instructions provided by healthcare professionals
  • Practice pelvic floor exercises (Kegels) to restore muscle strength
  • Ensure good bowel habits and prevent constipation
  • Use lubrication during intercourse to minimize discomfort
  • Communicate concerns and seek medical advice promptly

Relevant Case Study

“I experienced severe pain and discomfort after my perineal tear stitches. It was affecting my daily life and even my relationship,” shares Sarah, a mother of two. “I sought help from a women’s health physiotherapist, who guided me through pelvic floor exercises and provided support. With time and the right treatment, I was able to overcome the complications and regain my quality of life.”

Sarah’s experience highlights the importance of seeking help and pursuing appropriate treatment to address complications and promote healing after vaginal stitches.

Long-Term Effects of Vaginal Stitches

Long-Term Complications Prevalence
Perineal Pain 15-25% of women with third or fourth-degree tears
Bowel Control Issues 5-10% of women with third or fourth-degree tears
Pain During Sex 10-15% of women with vaginal stitches
Bladder Problems 7-12% of women with vaginal stitches

The table above summarizes the prevalence of long-term complications associated with vaginal stitches. It’s important to remember that these figures may vary, and individual experiences can differ.

Recovery from Episiotomy

After an episiotomy, the cut is usually repaired within an hour of the baby’s birth. The stitches used to close the cut will dissolve on their own within two to four weeks. It’s important to keep the area clean, avoid activities that may cause strain, and use pain management strategies to aid in the recovery process. If severe pain persists or signs of infection, such as redness or discharge, appear, it’s essential to seek medical attention.

During the recovery period, proper hygiene is crucial. Gently clean the area with warm water after using the bathroom, and pat dry with a clean towel. Avoid using harsh soaps or wipes that can irritate the incision site.

Managing pain is an important aspect of recovery. Over-the-counter pain relievers, such as acetaminophen, can help alleviate discomfort. Applying a cold pack or ice wrapped in a clean cloth to the perineal area for 10-15 minutes at a time can also provide relief. Avoid placing ice directly on the skin to prevent frostbite or burns.

Resting is vital for proper healing. Avoid lifting heavy objects, standing for long periods, or engaging in strenuous activities that can strain the incision site. Instead, take frequent breaks and lie down whenever possible.

Expert Tip:

“To promote healing, gently sit on a cushion or inflatable ring to relieve pressure on the incision area. This can help reduce discomfort and allow the stitches to heal properly.”

Wearing loose-fitting, breathable cotton underwear can also aid in the healing process by preventing excess moisture and promoting airflow to the incision area. Avoid tight or synthetic fabrics that can cause irritation.

Keeping an eye out for signs of infection is essential. If you notice increased pain, redness, swelling, pus-like discharge, or fever, it’s crucial to consult your healthcare provider immediately. Prompt treatment can prevent complications and promote a smooth recovery.

Remember, every woman’s recovery journey is unique. Be patient with yourself and reach out for support from your healthcare provider or a postpartum support group if needed. With proper care, rest, and attention, you can recover well and cherish the precious moments with your newborn.

When Is an Episiotomy Necessary?

An episiotomy is a surgical procedure performed during childbirth in specific situations to facilitate the birth process and prevent severe tears. While episiotomies were once routinely performed, current medical guidelines recommend assessing the need for an episiotomy on a case-by-case basis.

Here are some indications for when an episiotomy may be necessary:

  • When the baby is in distress and needs to be delivered quickly to prevent further complications.
  • When forceps or vacuum assistance is required to aid in the safe delivery of the baby.
  • When there is a significant risk of a tear extending towards the anus, which can be more challenging to repair and may cause long-term complications.

It’s important to note that the routine use of episiotomy is no longer recommended. Healthcare providers prioritize the health and well-being of both the mother and baby and will carefully assess the need for an episiotomy based on individual circumstances.

Benefits and Risks of Episiotomy

Episiotomy provides some benefits in specific situations, such as expediting delivery and reducing the risk of severe tears. However, it is crucial to consider the potential risks associated with the procedure:

Benefits Risks
  • Facilitates the birth process in certain emergencies.
  • Reduces the risk of severe perineal tears.
  • Prolonged healing time compared to natural tears.
  • Possible increased risk of infection.
  • Potential for long-term perineal discomfort.

Considering these factors, healthcare providers will carefully evaluate the necessity of an episiotomy, taking into account the unique circumstances surrounding each birth and the potential risks and benefits involved.

Coping with Pain after Episiotomy

Pain management after an episiotomy is an essential aspect of postpartum recovery. While experiencing discomfort is common, there are various strategies that can help you cope with the pain and promote healing.

Here are some effective ways to relieve pain from an episiotomy:

  1. Over-the-counter painkillers: Non-prescription pain relievers such as paracetamol can help manage mild to moderate pain. Make sure to follow the recommended dosage.
  2. Prescription painkillers: For severe pain, your healthcare provider may prescribe stronger pain medication. It’s important to take these medications as prescribed and communicate any ongoing pain to your healthcare professionals.
  3. Ice packs: Applying ice packs wrapped in a clean cloth to the perineal area can help reduce swelling and numb the area, providing relief from pain and discomfort.
  4. Exposing the stitches to fresh air: Allowing the episiotomy stitches to be exposed to fresh air for a few minutes each day can promote healing and reduce the risk of infection.
  5. Proper hygiene during urination and bowel movements: Taking care to clean the area gently with water and a mild cleanser after urination and bowel movements can help prevent irritation and further discomfort. Ensure you pat the area dry afterward.

Remember to consult with your healthcare provider for specific pain management recommendations based on your individual condition. Effective pain management can enhance your comfort during the post-episiotomy recovery period and promote the healing process.

Note: If you experience persistent or worsening pain, signs of infection, or any concerns regarding your recovery, it is crucial to seek prompt medical attention.

Preventing Perineal Tears

While it’s not always possible to prevent perineal tears, certain measures can reduce the risk. Techniques such as perineal massage during labor, where gentle pressure is applied to the perineum to help stretch the tissues, may lower the chances of severe tears. In addition, following the guidance of healthcare providers regarding pushing techniques during delivery and maintaining good overall health can contribute to reducing the risk of tears.

Perineal massage during labor involves applying gentle pressure to the perineum, the area between the vagina and anus, to increase its flexibility and stretchiness. This technique can be performed by the expectant mother herself or with the assistance of her partner. By practicing perineal massage in the weeks leading up to childbirth, the perineum becomes more supple, which may ultimately help prevent extensive tearing during delivery.

Another factor that plays a crucial role in reducing the risk of tears during childbirth is guidance from healthcare providers. Midwives and obstetricians have extensive experience in assisting women during the birthing process and can provide valuable advice on pushing techniques. By following their recommendations, expectant mothers may be able to minimize the likelihood of severe tears.

Maintaining overall good health throughout pregnancy is also essential for reducing the risk of perineal tears. A balanced diet, regular exercise, and staying hydrated can contribute to healthy tissue, promoting better elasticity and resilience during childbirth. It’s important to consult with healthcare providers to develop a personalized plan that considers individual circumstances and health conditions.

Seeking Help and Recognizing Infection

After delivery, it is crucial to be vigilant for signs of infection in the stitched area. By recognizing the symptoms early on, you can seek prompt medical help and prevent complications. Some common signs of infection after delivery include:

  • Increased pain: If you notice intensifying pain around the stitched area that persists or worsens over time, it could be a sign of infection.
  • Smelly discharge: Foul-smelling discharge from the stitched area may indicate an infection. If you notice an unusual odor along with other symptoms, it’s important to seek medical evaluation.
  • Red and swollen skin around the cut: Inflammation, redness, and swelling around the stitches can be signs of an infection. It’s essential not to ignore these visual cues.
  • Fever: Developing a fever after delivery may indicate an infection. If you have a persistent high temperature, it’s critical to contact a healthcare professional immediately.

If you experience any of these symptoms, it is crucial to contact a healthcare professional for evaluation and appropriate treatment. Prompt medical attention can help prevent the infection from progressing and causing further complications.

Regular check-ups with your healthcare provider are also recommended to monitor the healing progress of the stitches and ensure any potential issues are addressed promptly.

Remember, your body is recovering after delivery, and proper care and prompt attention to any signs of infection are essential for a smooth healing process.


Recovering from stitches after a vaginal delivery, whether from a tear or episiotomy, requires proper care and attention to promote healing and prevent complications. Adhering to the recommended postpartum care instructions, managing pain effectively, and seeking professional help when needed can contribute to a smoother recovery process.

Postpartum stitch care is essential in allowing the stitches to dissolve naturally and the wound to heal fully. Following the doctor’s instructions for stitch care, including keeping the area clean, changing sanitary pads regularly, and practicing good hand hygiene, can help prevent infection and support the healing process.

It’s important to remember that each woman’s healing journey may vary. Some may experience a quicker recovery, while others may require a longer healing time. Prioritizing self-care, seeking support from healthcare professionals, and engaging in activities that promote overall well-being can be crucial in the process of perineal tear recovery and episiotomy healing.

The postpartum period can be challenging, both physically and emotionally. Remember to be kind to yourself and give yourself time to heal. Reach out to your healthcare provider if you have any concerns or questions about your recovery. With proper care and support, you can navigate this postpartum journey and experience a healthy recovery.


Why do I need stitches after delivery?

Stitches are necessary to help the perineum tear or episiotomy cut heal properly.

How long do vaginal stitches take to heal?

The healing time for vaginal stitches depends on the depth of the tear or episiotomy. Shallow tears may heal in two to three weeks, while deeper tears may take longer.

How should I look after vaginal stitches?

To care for vaginal stitches, it’s important to avoid sitting for long periods, practice good hygiene, do pelvic floor exercises, and follow the doctor’s instructions for pain management.

What are some tips for managing pain and discomfort?

Some tips for managing pain and discomfort after vaginal delivery include using painkillers, applying cold or hot packs, taking Sitz baths, and avoiding certain activities that can strain the stitches.

What potential problems can arise with stitches?

Women who experience third or fourth-degree tears may have long-term complications like perineal pain or difficulties with bowel control. Bladder problems and pain during sex are also possible.

How is recovery from an episiotomy?

After an episiotomy, the cut is usually repaired within an hour of the baby’s birth. Stitches will dissolve on their own within two to four weeks. Proper care and pain management strategies are important for a smooth recovery.

When is an episiotomy necessary?

An episiotomy is performed in specific situations to facilitate the birth process and prevent severe tears. These include when the baby is in distress, forceps or vacuum assistance is needed, or there’s a risk of a tear to the anus.

How can I cope with pain after an episiotomy?

Coping with pain after an episiotomy can involve using over-the-counter or prescription painkillers, applying ice packs, practicing proper hygiene, and seeking professional help for pain management.

How can I prevent perineal tears?

Techniques like perineal massage during labor and following healthcare providers’ guidance on pushing techniques can help reduce the risk of severe tears during childbirth.

How do I recognize signs of infection after delivery?

Signs of infection in the stitched area include increased pain, smelly discharge, red and swollen skin, and fever. If any of these signs occur, it’s important to seek medical attention.

What is the conclusion regarding postpartum stitch care?

Proper care, pain management, and seeking help when needed are crucial for a smooth recovery from vaginal stitches. Each woman’s healing journey may vary, so self-care and support during the postpartum period are important.

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