Episiotomy Scar Problems
by Barbara Parker, RN, ARNP, CNM

Q. When I gave birth to my son almost two years ago I had an episiotomy. Now when I get my period, on the first day I get a burning sensation where the episiotomy was. On the second day of my period, the burning is gone completely. I also have slight discomfort during sex. It doesn't bother me all the time during sex, just once in awhile I get a burning feeling during intercourse. Yesterday after sex, I had that burning pain with a little bit of blood and realized I have a tiny "cut". Is this normal? I thought after an episiotomy healed, that was it.

A. Everyone forms scar tissue differently, and that "burning" sensation is the scar tissue stretching and possibly even tearing internally. The fact that it stays around for a couple of days means that there's inflammation there. As for it hurting on the first day or two of your cycle, that is a response to the increased blood flow to that area, causing some inflammation of the tissues. The tiny "cut" will heal all by itself; you just need to keep it clean and as dry as possible. Put a little topical antibiotic on it if you want which will help it heal and keep it more comfortable.

Tell all of this to your doctor or midwife. That area needs to be checked carefully to be sure the episiotomy healed properly. It's likely that you have some scarring. This sounds absolutely awful, but it may be possible to inject some steroid solution into the scar to decrease the inflammation on a long term basis. Honest, it's not as awful as it might sound!

More on episiotomies:
  • Get Through Childbirth in One Piece! by Elizabeth Bruce, MA, CCE
  • Are Episiotomies Necessary? ~ a message board archive
  • Preventing an Episiotomy by Nancy Sullivan, CNM, MS, FACNM
  • Episiotomy vs Tearing by Nancy Sullivan, CNM, MS, FACNM
  • Third Degree Tearing by Barbara Parker, RN, ARNP, CNM