The birthing process comes with many unexpected realities. We expect pain, joy, and even the unknown. One less known fact of delivery is vaginal tearing. Vaginal tearing occurs most commonly because the baby’s head is too large for the opening. Other factors can also raise your risks, such as being a first-time mother, having a larger baby, longer delivery, or the use of birthing assistance like forceps or the vacuum.
Vaginal tearing is often a natural part of the birthing process and should not be feared. In many cases, it heals back quickly, usually within ten days. The healing process for natural vaginal tearing also tends to be quicker than that of an episiotomy. Episiotomy is a surgical cut to the vaginal opening to prevent uncontrolled tearing during birth.
FOUR DEGREES OF VAGINAL TEARING
There are four different degrees of vaginal tears. Depending on the severity of the tear, you may require stitches. For a higher degree tear, your recovery time could be a bit longer and you might experience more pain or discomfort. With some of my children’s births, I hardly noticed the vaginal tearing. With others, it was significant and took patience.
VAGINAL TEARING TREATMENT
There were some vaginal tearing treatment methods that my doctor recommended that really did work well.
Your body cannot heal unless you rest. You have your hands full trying to take care of your baby so rest as often as you can and allow your body to naturally go through the process of healing. There are certain activities that I found aggravated the stitches or just prolonged healing. Walking too much, sitting too long, and lifting anything heavier than my baby were a bad idea. My doctor recommended no exercise or sexual activity until after the six-week checkup to ensure that everything did heal properly. In the meantime, take naps often, even short ones. Try to eat healthy and drink lots of fluids to prevent constipation.
2. STOOL SOFTENER
I got stool softeners after the delivery to prevent strain during a bowel movement as constipation is common during postpartum recovery. My doctor recommended using them for a couple of weeks, which I think is a great idea.
3. SQUATTY POTTY
Another great way to avoid putting pressure on the perineum while recovering from a vaginal tearing delivery is to use a squatty potty to empty your bowels. It keeps you in a squatting position that doesn’t compress the rectal canal. This shortens the time you spend on the toilet and minimizes the pressure on the perineum.
4. APPLYING COLD PACKS
The best way I found to relieve the discomfort was by using cold packs. In the hospital, the nurses used ice cubes in a sealed plastic bag and wrapped in a cloth or a baby diaper. The sharp corners on the ice cubes can be really painful against the tear, even through a diaper. Luckily, there are softer perineal cold packs filled with gel that can be applied without any discomfort. In the days following the delivery, I applied cold packs for 20 minutes at a time every few hours and it really helped with the swelling, bruising, and pain. Don’t apply too long as it can do damage.
5. SITZ BATH
My nurse at the hospital recommended soaking the perineum in a warm sitz bath at least twice a day. There are many different sitz bath devices that can be placed in the toilet to help with this. You can also just sit in a tub with water up to your hips. In fact, sitz bath got its name from the German “Sitzbad”, which just means sitting in a bath.
For me, taking a sitz bath never really worked in the stressful first weeks of taking care of my newborn and I think my perineum recovery suffered as a result. I’ve heard from a couple of friends who tried it that this is an effective technique and I regret not taking the time to make it work.
6. PERINEAL MASSAGE
Keeping muscles healthy and strong can help avoid complications. Perineal massage can be beneficial both in preparation for and recovery from delivery. Make sure to consult with a pelvic floor physical therapist before doing perineal massage. My physical therapist didn’t recommend perineal massage until my vaginal tear stitches had properly healed.
Kegel exercises is another way to prepare the pelvic muscles for delivery and recover the muscles after birth. But it’s actually really hard to do kegels correctly. Some 25% of women do them wrong! A physical therapist can help you learn how to do kegels right and determine whether it’s the right fit for you. Some women have an overly tense pelvic floor and so should not do kegels.
CONTACT YOUR DOCTOR
A few months after my delivery, I discovered a painful pink spot in the stitched part of my perineum. I showed it to a number of doctors, before one of them figured out that it was granulation tissue and burned it off with silver nitrate. She explained that I was essentially “healing too well.” And eventually, the pink spot disappeared. But the road there was painful and frustrating. One of the doctors that I saw speculated that the area was too moist to heal and gave me the completely impractical advice to go commando!
But that’s not to say that you shouldn’t see a doctor if you’re not healing well. If you see any larger blood clots on your pad, any foul-smelling discharge, or your symptoms get worse, call your doctor as you could have an infection or other complications.