Episiotomy, Healing and Sexual Function

An episiotomy is a surgical cut made in the tissue between the vaginal opening and the anus, called the perineum, during the final stage of childbirth. It was once routine in many hospitals. Medical bodies now describe it as a procedure reserved for particular circumstances rather than a default step.

Tissue changes after childbirth, whether from a cut or a natural tear, can affect comfort during sex for some people. Disputes over birth-related injuries occasionally reach Canadian courts as claims of medical negligence.

What the procedure involves

The incision is repaired with stitches after delivery. Clinicians describe tears and cuts by degree, from superficial to those involving the muscle of the anal sphincter. Healing usually takes several weeks, and the area can feel tender, tight or sensitive during that period.

Scarring and sexual function

Scar tissue forms as part of normal healing. In some cases it becomes thick or restrictive, which can cause pain during penetration, a symptom known as dyspareunia. Hormonal changes linked to breastfeeding, pelvic floor muscle tension and nerve sensitivity can also contribute, so a single cause is not always identifiable.

Reported outcomes vary widely. Many people experience no lasting difficulty, while others report discomfort that continues for months or longer. Health professionals who treat these concerns include family physicians, gynecologists, midwives and pelvic floor physiotherapists.

Legal context in Canada

Health care in Canada is delivered under provincial and territorial systems, and physicians are bound by standards of care set through professional colleges and court decisions. A negligence claim generally requires showing that care fell below an accepted standard and that the shortfall caused harm. Informed consent is also a separate issue, since patients are entitled to information about material risks of a procedure.

Quebec has its own civil law framework, so such claims there proceed under the Civil Code rather than the common law used elsewhere. Damages sought in birth injury cases can cover pain, loss of enjoyment of life and income, and courts assess each claim on its own evidence.