Pregnancy & Postpartum

12 Tips To Take Care Of Perineum Stitches After Vaginal Delivery

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Stitches after vaginal delivery can be painful. When a woman gives birth, the vagina widens to 10cm. If a baby’s head is bigger than 10cm in diameter, it has to come out of that opening and can tear up your perineum skin to accommodate the baby. In some cases, your doctor may perform an episiotomy.

If you are unfamiliar with the term perineum, it is the space between the vagina and the anus which often tear up and occasionally be cut (an episiotomy) during a vaginal birth to allow the baby to arrive into the world. After childbirth, you may have had sutures (stitches) to repair any perineal tears or an episiotomy.

These sutures (stitches) are generally dissolvable (also called absorbable sutures) are typically used for an episiotomy. You don’t have to go back to the doctor to have them removed; they will break down on their own within a few days.

Many women who give birth vaginally will suffer some form of perineal pain in the postpartum (after birth) period, even those lucky few with no tear. For some women, they are so painful that they mention it as part of the pain of delivery.  A woman’s body and life are rarely the same after childbirth, with so much going on with your body and the small person that just came out, we have a lot to manage, and you would want to get relieved from the perineum stitches pain as early as possible.

What causes internal tearing during childbirth?

A vaginal tear during childbirth can happen for a variety of reasons. A few factors that could cause a tear can include:

  • If it’s your first delivery.
  • A large baby
  • The position of the baby (face-up deliveries).
  • Use of forceps or a vacuum during delivery.
  • If you’ve had an episiotomy.

Tips for caring for your stitches after childbirth.

Once you are ready to leave the hospital, your nurses and provider will give you detailed instructions on how to care for yourself and your stitches, but sometimes they do not also if they are too busy like it happened in my case. By God’s grace, my child and I were pretty good after delivery, and in fact, they gave us discharge from the hospital within one day of delivery, which I hated, because you are not ready to do everything on your own in one day and feel very weak. However, they gave me few ointments to keep my stitches clean, but unfortunately, it did not work for me, and I was in terrible pain since my stitches did not seem to be healing even after ten days and were hard for me to sit and do basic chores. But when one of my sister, who is already a mother of 2 kids, gave me some ways to take care of my stitches plus with lots of reading, I was finally relaxed by my perineal pain within a week.  

Below are some of the tips that would help you get your Perineum stitches to heal faster.

1) Ice Pack:

Apply ice pack with a soft covering to your perineum after you give birth to reduce swelling and discomfort. These ice packs resemble the shape of sanitary pads and can be worn in your underwear. Make sure to cover it with a clean cloth to protect your skin from the cold. Do not use the ice pack for more than 20 minutes at a time, as it can cause nerve damage. 

2) Take a pain relief: 

Ask your health care provider to give you any over the counter pain relief like Motrin (Ibuprofen) (Don’t take asprin if you’re breastfeeding.) If you have an extensive tear, you may need prescription pain medication.

3) Postpartum Numbing Spray:

Consider trying a numbing spray. The cooling spray helps heal stitches and general discomfort after childbirth. Some women swear by these, and most hospitals still prescribe them.

4) Sanitary Pads: 

Sanitary pads are one of the essential items to include in your hospital bag. Although during your stay in the hospital after giving birth, the nurses will supply you with comfy mesh underwear and hospital-grade pads, not all women are a fan of this particular combination, and many prefer to have their supplies either for the hospital (if your nurse allows). Still, you can surely use your own once you head home. Make sure you change your sanitary pad every 2-4 hours and also, most importantly, avoid gel-based sanitary pads, so go for postpartum cotton sanitary pads.

5) Avoid Tampon or Menstrual Cups: 

Avoid using tampons or menstrual cups for the first 6 to 8 weeks after giving birth. During postpartum bleeding, you should ONLY use disposable cotton pads. While lochia is present, it is therefore important not to insert anything into the vagina, because no bacteria must be introduced that could then go back into the uterus. Whether you had a c/section or vaginal birth, the uterus still takes time to heal.

6) Squirt Bottle:

Use a squirt bottle or a mug to pour warm water on your perineum while you’re urinating. The water dilutes your urine, so it doesn’t burn as much when it comes in contact with your skin. Cleanse the area with another squirt afterward.

7) Wipe front to back:

Pat yourself dry from front to back to avoid introducing germs from the rectum into the vaginal area.

8) Sitting for a long time:

Avoid sitting for long periods while your perineum is still very sore. Resist sitting with crossed legs, or any sitting position that allows your labia to gape open if you have a tear or stitches. This assists in reducing strain on your perineum or stitches.

9) Sitz Bath:

You can use your bath tub if you have one or sitz bath toilet kit.

If you are using your bathtub for a sitz bath, then make sure it’s clean (better ask someone to clean it for you). Fill the tub with a few inches of water, add a little antiseptic recommended by your doctor.  Lay a clean bath towel (as it would be much more comfortable for a sore bottom to sit on a towel than a hard tub) on the bottom of the tub and sit down and relax for 15-20 minutes.

 But if you do not have a bathtub or you find this little inconvenient doing this since you have to fill the bathtub and get completely undress, so you should try Sitz bath toilet seat kit which is a shallow plastic basin with warm water with added antiseptic and position it over your toilet seat, then sit on it, with your perineum in the water. This way, you can soak your perineal area several times a day without having to fill a tub and completely undress. 

10) Stop Stressing about Poo:

For the first few times when you go to the toilet, sit in a lean-forward position, and use a clean toilet paper to support your stitches gently. This will protect your stitches and stop you from feeling that your stitches are going to split (they won’t). Doing a poo won’t make the tear any bigger, or make your stitches come away. Do not strain—just relax and take your time.

When you feel the urge to poop, don’t put it off. Waiting can make you constipated.
It’s understandable to feel vulnerable about this part of your body. Feeling tense will make it harder for you to do a poo, though. 

Try not to hold your breath to push or hurry it along – take your time and relax.  Eat plenty of fiber-rich foods, such as fruit and vegetables, wholemeal bread, and brown rice. This will help to soften your poo. Drink plenty of water to ease things along, as dehydration hardens poop, which makes it more difficult and uncomfortable to pass.

11) Do Kegel:

If you have taken Pregnancy classes, you would know how crucial legal exercise is during and after pregnancy. Kegel exercise is a form of pelvic floor exercise that involves squeezing and relaxing muscles in the pelvic and genital areas. Regular Kegel exercise during pregnancy and after you’ve given birth can help improve and maintain your bladder and bowel control by increasing the strength, endurance, and correct function of these essential muscles. This helps restore muscle tone, stimulate circulation, and speed healing. (Contracting your pelvic floor muscles supports the wound so you’ll feel less of a pulling sensation on your stitches when you move.)

12) Take Rest:

Get plenty of rest, and don’t take on any unnecessary chores. Save your energy for taking care of your baby and yourself so your body can heal.

Right Time to Have Sex After Delivery:

Postdelivery hormonal changes may make vaginal tissue thinner and more sensitive and might leave your vagina dry and tender, especially if you’re breast-feeding. There’s no definitive timeline that says how long you should wait to have sex after giving birth. However, most doctors recommend women to wait for about six weeks following vaginal delivery. 

Postpartum sex can be more pain than pleasure, as you might experience some discomfort during sex if you’re healing from an episiotomy or perineal tears. Your vagina, uterus, and cervix have to “return” to a standard size, too. In short, your body needs some time off after delivery, although even after six weeks, you might not feel ready, so take your time and do it when you feel right.

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