If you have an episiotomy, the wound should be sutured shortly after the birth. However, you need to take care of the wound as the stitches can come out. If you think they have come out, you need to seek advice from your GP or Community Midwife as soon as possible.
Repairing an episiotomy
An episiotomy is when the perineum is deliberately cut in order to widen the vaginal opening. This will facilitate the delivery, which may be needed if a forceps delivery is required or the birth needs to be sped up due to mother/foetal distress.
After the birth, the episiotomy wound will be sutured together with dissolvable stitches. Before this is done, a clinician should check to see whether any other damage has been done. If a perineal tear is identified, this should be sutured at the same time.
It is important to note that a midwife can suture an episiotomy. But if a 3rd or 4th degree tear is diagnosed in addition to the episiotomy, both wounds should be repaired by an experienced surgeon in theatre.
Caring for an episiotomy to prevent stitches coming out
Before leaving hospital, you should be advised as to how to care for the episiotomy wound. This should include keeping the wound clean and getting air to the area.
You should also be given medication to help prevent the wound from breaking down. Primarily, you may be given laxatives as this will ensure you do not have to strain when passing a stool, something which can break the stitches. You may also be given antibiotics as this will help prevent an infection, which can cause the stitches to break down.
Why might episiotomy stitches come out?
As mentioned above, the most common reasons why episiotomy stitches might come out include infection and straining to pass a stool. There are also other reasons – for example, the wound may be poorly sutured or the patient is too active and damages the stitches.
Whatever the cause, if your episiotomy stitches do come out it is important to seek advice from a GP or Community Midwife. Further treatment may be required, depending upon how well your episiotomy wound has healed. You may need re-stitching, while if you have an infection you will need antibiotics.
Episiotomy stitches have come out – is this negligent?
If your episiotomy stitches have come out, it may be a case of bad luck, in which case you will not be able to make a claim. But if medical error is to blame, you could be eligible to compensation. This might apply, for instance, if you were not given antibiotics and you should have been. You will also be able to claim if you had a 3rd or 4th degree tear underneath the episiotomy but this was not diagnosed and repaired.
For more information on claiming for a missed tear, or a negligent episiotomy repair, please get in touch with us today.