Oh No- I Tore My Vagina!

While giving vaginal birth is beautiful, it is also pretty painful. From labour pains, pushing out a baby, delivering the placenta (afterbirth) and the evacuation of clots… the whole process can hurt- a lot!

To make matters worse, having a vaginal delivery can lead to tears or the need for an episiotomy which is a cut made by the midwife or doctor to widen the space.

Image result for episiotomy
Please click photo for source

Usually these tears are perineal lacerations, and there are different degrees if them and are divided based on the structures involved this includes from just the vaginal mucosa to the anal mucosa… basically the vagina to the anus.

Usually they are repaired by suturing if they’re actively bleeding and the degree they are. Episiotomies are always repaired, usually as soon the placenta is out and during that hour after (fourth stage) as they bleed heavily.

Another area that can be torn is the cervix (or neck of the womb). If these lacerations are not bleeding they aren’t repaired. Sometimes, these types of lacerations have to be repaired in the operating theatre under sedation so that they can be examined and repaired properly.

Aftercare of the perineum is important after giving birth- whether or not there’s a laceration that needed to be sutured. It is a traumatic experience and usually leaves bruises and small cuts behind.

Aftercare includes:

Sitz Baths

In order to do sitz baths correctly, a large enough bucket (that is only used by the woman) is needed. When she sits in this bucket it must cover her anus and vulva. Warm water is used and filled with enough salt until it is cloudy. A sitz bath is done twice per day and after passing stool as it helps with healing. I usually say to do it for 6 weeks but up to two weeks is also generally fine.

Pro tip: the water temperature should be tested with the elbow to see if it is warm enough to sit in.

 

Pain Medication and Prophylactic Antibiotics

If suturing is done, generally broad spectrum antibiotics are given and pain medication.

Stool Softeners and High Fibre Diet

This really helps with pain, keeping the area clean and preventing straining.

 

Always talk with your OBGYN for more information if you’re planning to get pregnant, are pregnant or just had a baby!

Samantha C. Johnson

Featured image can be found here.

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