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 and nothing to worry about. 9 out of 10 women tear to some degree during giving birth due to the baby stretching the vagina, but most are just minor tears. 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 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 and usually heals on its own. A second-degree tear affects the perineum muscle as well as the skin and will usually need stitches. Only 10 per cent of women will have serious third or fourth degree tears; 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 as well as the rectum inside the anus.

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. Midwives usually stitch less serious tears.

Other treatment

You’ll be given pain relieving drugs to ease any discomfort you may have. Intravenous antibiotics may also be given to avoid the risk of infection.

You may also be offered laxatives 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. Avoid perfumed products as they may cause irritation.
  • Change sanitary towels frequently: This makes the risk of infection less likely; wash your hands after changing them too.
  • Drink plenty of fluids: Experts say you need to drink two to three litres of water a day, 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.
  • Start pelvic floor exercises: These help boost blood flow to the area aiding 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 – this can help avoid bladder weakness problems. If you experience problems, you need to see a physiotherapist.

Mum's story

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

References

  1. https://www.rcog.org.uk/en/patients/
  2. http://www.nhs.uk/