A typical episiotomy or second-degree tear which involves skin and muscle, requires stitches and usually heals in two to three weeks. (The stitches dissolve on their own during this time.) Some women feel little pain after a week, while others have discomfort for a month. If you have a more serious tear that extends to the rectum (a third-or fourth-degree laceration), you may have pain and discomfort for a month or even longer.