One of the top concerns for mama’s to be is perineal tears after a vaginal delivery. Tears are more common with a first pregnancy and are ranked from 1st degree tears, 2nd, 3rd up to 4th degree tears. 1st degree tears are very superficial and 4th degree tears are much more significant as they extend through the vaginal muscle and extend down into the rectal muscle.
A third-degree tear
A perineal tear is a laceration to the area between the vagina and the rectum. A 3rd degree tear involves deep layers of vagina and muscles around the anal sphincter.
After delivery your healthcare provider will let you know what kind of tear, if any, you have and will provide some education on how to care for it.
Tips and tricks
No matter what degree of tear you have, they can all be pretty uncomfortable. It is a difficult place to have stitches as the area is already sensitive from just delivering a baby and of course you have to use the washroom and spend some of your day sitting on your bottom! Of course, the larger the tear, the more discomfort we can expect and the longer it will take to heal.
When your healthcare provider is putting the stitches in, they will put some freezing into the area first. That freezing will help in the early postpartum hours with the discomfort. Once that wears off you will likely need to take some Tylenol and or Naproxen to help ease the pain. Tylenol and Naproxen can be taken at the same time as they work differently to control pain. Naproxen works well for inflammation, so if your perineum has some swelling then you should consider taking this!
Ice can be put on the perineum as well to help with pain and swelling. The rules with an ice pack are 20 minutes on the skin, 20 minutes off the skin to avoid nerve damage and repeat if desired. You would also want a thin barrier such as a cloth in between the ice and the skin.
Lots of soon to be moms will make padsicles (see article) as the ingredient’s aloe vera and witch hazel can help with the healing process.
Rinsing the area after using the washroom is really important if you have tears as well. Rinsing the perineum postpartum will keep stitches clean and therefore reduce the risk for infection. After delivery, you will be given a plastic squirt bottle (peri-bottle) to fill with lukewarm water and use to squirt the area to keep clean after using the washroom. Sitz baths work similarly, as they are a small plastic tub that fit over the toilet bowel. You fill with lukewarm water and sit in it for a few minutes to cleanse the skin.
Rest is best! This is hard when you have a new baby to care for but your healthcare provider will suggest taking it easy for a least 2 weeks after giving birth.
Your healthcare provider may also encourage you to pick up an over-the-counter stool softener, such as Colace, and take regularly to avoid having to stain to have a bowel movement.
Third degree tears are a more significant tear as they extend deeper into the vaginal muscle, but by adding the above tips and tricks into your postpartum routine you can have your bottom feeling better quickly! It is a very sensitive area to have stitches but thankfully the area heals and recovers fast and stitches start to fall out after only a few days postpartum. Tears usually heal within the first week postpartum but the discomfort can continue for a few weeks afterward.