Episiotomy Care and Perineal

After vaginal birth, some perineal tenderness, bruising, and swelling can be expected. The nursing task is to determine whether the tissue is healing or whether bleeding, infection, haematoma, wound separation, anal sphincter injury, or urinary retention is developing. That distinction depends less on one isolated finding than on a complete examination and the direction of change over time. For the Canadian RPN, assessment, comfort measures, documentation, teaching, and escalation occur within provincial scope, employer policy, and individual competence. An episiotomy is not routine care: it is an individualized incision used when the anticipated benefit of expediting birth or creating space outweighs the added tissue injury. After any vaginal birth, the perineum and vaginal canal require systematic assessment because a missed sphincter injury can heal inadequately and cause lasting anal incontinence.