If you’re reading this after giving birth you’ll already know that tears and stitches can leave you feeling a little sore and uncomfortable.
Equally though, tears are incredibly common. About 9 out of 10 women will have some degree of vaginal tearing during giving birth due to the baby stretching the vagina and perineum, but most are just minor. Most of these tears affect the perineum – that’s the area between your vagina and your anus.
In some circumstances, where the baby needs to be delivered quickly to make the baby’s birth easier or safer, your midwife or doctor may have made a cut in the perineum – the medical word for this is an episiotomy.
The tears or cuts are repaired after birth with dissolvable stitches with a local anaesthetic so it’s not painful.
Types of tears
There are four different grades of tears.
A first degree tear is the least serious affecting just the skin or vaginal mucosa without muscle involvement.
A second-degree tear affects the perineum muscle as well as the skin and will usually need stitches.
A third-degree tear extends down towards the anal sphincter (the muscular ring around the back passage) and a fourth-degree tear extends even further to the anal canal or rectum.
All tears should be assessed by your health professional after giving birth and if it’s a third or fourth-degree tear you may need repair surgery performed by a doctor. Most first or second degree tears may require some amount of stitching.
How to deal with stitches post-childbirth?
You’ll be given pain relieving drugs to ease any discomfort you may have. Antibiotics may be prescribed to avoid the risk of infection.
You may also be offered laxatives or a stool softener to avoid the risk of constipation – straining to pass a bowel movement can put pressure on your stitches so should be avoided.
What stitches really feel like
Stitches can take up to six weeks to dissolve and heal completely. To begin with you may feel sore and uncomfortable for up to a week, many women report pain and tightness are worse after a few days as the stitches 'knit' together and become tighter. If you feel the stitches are too tight – tell your midwife or nurse, as they may be able to snip them to relieve pressure.
6 ways to speed up the healing
- Keep clean: It’s important to keep the whole vaginal area clean, so take a bath or shower at least once a day and wash your perineal area more frequently.
- Change sanitary pads frequently: This reduces the risk of infection; wash your hands before and after changing them too.
- Drink plenty of fluids: This will help to keep your bowels open regularly and avoid constipation. More fluid will also make your urine less concentrated and less likely to sting the stitched area.
- Eat a healthy diet: A healthy diet including fruit, vegetables, cereals, wholemeal bread and pasta will also help avoid constipation.
- Rest: Avoid heavy lifting, housework or vigorous exercise in the first few weeks or until your doctor clears you to do so.
- Start pelvic floor exercises: Once your doctor advises, you can start pelvic exercises to aid the healing process. Ask for advice on how to do them correctly – some hospitals will offer expert advice from a physiotherapist.
When to call medical help
Redness in the area, increased pain or an offensive smell can be a sign of an infection so seek medical advice if you notice this. Other problems to look out for include difficulties controlling your bowels movements, a sense of urgency to open your bowels or failure to control wind.
Longer term follow up
Many women who’ve experienced third or fourth degree tears may be apprehensive about sex – it shouldn’t be painful so if it is, mention this to your doctor at your follow up appointment. Most women who have had serious tears are offered an examination after the birth just to check everything is okay.
Keep practising pelvic floor exercises as advised by your doctor – this can help avoid bladder weakness problems. If you experience problems, you may need to see a physiotherapist.
I felt quite sore after my stitches so my midwife advised me to lie on my side as much as possible and sit on cushions if I was upright. The stitches felt tightest after about three days but then started to ease. I took lots of baths and kept the stitches clean and they healed without any problems.
Mum of baby, 2 months