The state of your perineum will depend on your labour and delivery. Some women experience no tears, only swelling and discomfort, but many will have tears on their perineum when delivering a baby. A perineal tear may not have been on your birth plan, but this article will discuss how best to recover and heal perineal tears for a smoother after birth experience.
What are perineal tears?
The perineum, also known as the area between the vagina and the anus, usually stretches but can tear during pregnancy, especially when women give birth for the first time. As your baby’s head stretches your perineum, you will feel a burning sensation, and as your tear occurs, that burning stops.
There are different types of tears, and they can be placed into four categories depending on their severity; first degree, second degree, third degree and fourth degree. A first-degree tear involves just the skin of your perineum, and if it is not bleeding, doctors will not usually advise you to have it sutured. Perineal tears are common with first births, with around 9 out of 10 women having them, and less so with every subsequent delivery (about 7 out of 10).
What is an episiotomy?
Occasionally an episiotomy, a surgical cut of your perineum to help you give birth, may be required. Your midwife or obstetrician will always inform you of why your midwife or obstetrician wishes to do it, and they will need your permission to do it as it is a medical intervention. Episiotomies are no longer routine practice, and the area will be numbed, although, like tears, they do not hurt as they happen.
What happens if I have a tear or a cut?
If you sustain a second-degree tear, the advice nowadays is that having it sutured reduces the risk of infection and allows it to heal quicker. Suppose your tear is bleeding, whether the first or second degree; you will be advised to have sutures to prevent unnecessary blood loss. You will always have good pain relief while having your perineum repaired. Your legs will usually be placed in stirrups, and the repair usually takes around fifteen minutes and maybe sooner if the tear is small. The material used nowadays dissolves, so there is no need to have the sutures removed.
Tips on healing perineal tears naturally
You can take various steps to recover and heal perineal tears naturally in the postpartum period.
1. Apply witch hazel
Witch hazel has many benefits and is a popular product for pregnant women. It’s excellent for pregnancy haemorrhoids, post-natal swelling and healing stitches. You may find that freezing and then sticking witch hazel pads to your panties is good for pain relief of symptoms as it soothes and cools the area. Use for 10-20 minutes daily for up to every 2 hours.
2. Soak in a bath
Sitz baths can be great for perineal tears after an episiotomy. Soak yourself in a postpartum sitz bath, which sits on top of a toilet, and you can soak your bottom in a few inches of water. The combination of warm water and salt is very soothing. It can help with pain, swelling, stitches and haemorrhoids and general post-natal healing leading to a quicker recovery. You can add herbs, essential oils and salts to your sitz bath for extra comfort. The best is to do sitz baths three times a day for 15-20 minutes.
3. Apply Ice Packs
An ice pack is fantastic for reducing swelling after the tear. You can apply a cool compress by freezing water to the area to relieve and ease the pain.
4. Have a soothing post-natal spray
You can also make a spray for using on the perineum after birth. It’s a mixture of calendula tincture diluted in water, aloe vera gel, blue chamomile essential oil and/or lavender oil. Ensure that you use 1% (or less) of essential oils, or it could be too concentrated. If this is not possible, just use the aloe vera and calendula. Alternatively, My Expert Midwife’s ‘Spritz for Bits Perineal Spray’ is designed for this use and is excellent for soothing and cleansing this area.
5. Make sure you poo carefully
After giving birth, many women are anxious about bowel movements which can be uncomfortable. If you are using pain medication, this can lead to constipation, making it difficult to pass stool. Therefore, it is necessary to stay hydrated and eat foods rich in fibre that may be able to help. You can also use stool softeners to ease constipation.
6. Get plenty of rest
Giving birth is very demanding physically and mentally, so make sure you get plenty of rest to recover. Listen to your body and take all the help that you can get. Many women suffer from postpartum depression, so you could try some relaxation techniques to calm the mind. Be gentle with yourself and keep your activity level low so as not to overwork. Take your time when moving, getting up, and sitting down as it may irritate the perineum. The longer you rest, the faster you will recover and be back to normal.
7. Use A Peri Bottle
A peri bottle can be helpful in postnatal recovery after natural childbirth. If you need to go to the toilet, you must do so carefully. The bottle can help if you rinse before wiping, making wiping more gentle. A peri bottle may also help with urination and emptying the bladder.
8. Do Kegel Exercises
As soon as you can, restart your pelvic floor exercises. Pelvic floor exercises work the muscles around your vagina and anus to enhance blood circulation and thus help with the healing process.
9. Get Plenty of fresh air
Your perineal tear will heal faster if it has fresh air. You could do this after a sitz bath; go and lay down for 10 minutes with nothing on but make sure that you create some space between your legs so that air can reach the area. You could rest, feed and hold your baby during this time.
Let My Expert Midwife help you
If you suffer from a tear or episiotomy following childbirth, it’s essential to keep the area clean and regularly change your sanitary pads. The area will feel swollen and painful. Most tears heal naturally within the postnatal period but can be uncomfortable. If needed, you can use pain medication advised by your doctor or midwife and some essential oils.