Perineum Care After Birth
Tearing during birth is common, scary, and treatable!
Let's talk about this often overlooked aspect of childbirth, from what the perineum is to how to heal those tender tears. Plus, tips to reduce your risk of tearing in the first place!
Your perineum is the skin between the vaginal opening and the rectum. There are four degrees of tearing. The first and second degree tears are the most common.
1st degree: slight tear of perineal skin, doesn't require stitches, heals within a few weeks
2nd degree: involves perineal skin and muscle, requires stitches, heals in a few weeks.
3rd degree: extend into the muscle (anal sphincter), require stitches - sometimes done in an OR, takes weeks to heal.
4th degree: most severe, tear all the way through anus into the rectum, require repair in OR, takes longer than a few weeks to heal
Perineal trauma can also happen with an episiotomy (a surgical cut made at the base / opening of the vagina to have the baby born more quickly due to malpositioning or medical necessity). Research shows that episiotomies increase the risk of vaginal tears and infection, so they are no longer routinely performed. Typically episiotomies are only performed in necessary situations.
If you’re looking for ways to reduce tearing: start with a childbirth class, see a pelvic floor therapist. Do your research – what is the episiotomy rate at your hospital or with your specific provider? Communicate your preferences with your provider before birth.
Here are some at-home treatments to soothe tender tissues:
Cold Packs: which you can take home from the hospital, buy online, or make yourself with aloe, witch hazel, and frozen pads.
Sitz Bath: which can be take home from the hospital, or purchased online. Soak in lukewarm or cool water for 15-20 minutes at least once a day.
When to Call Your Doctor:
heavy vaginal bleeding
fever of 100.4 or higher
pain worsening or severe
an incision or stitches that are beginning to separate
pain while urinating or trouble passing stool
flu like symptoms
vaginal swelling, odor, or discharge
Disclaimer: Doulas are not medical personnel and do not diagnose, perform any medical exams or clinical tasks. Information presented above is not intended as a substitute for the medical advice of a properly licensed health care professional.
For more help navigating the seismic shift into parenthood, reach out to the Boston Area Doulas team.
www.bostonareadoulas.com
