How to Recover From a Perineal Tear During Childbirth

Many women suffer from perineal tears during childbirth, resulting in damage that can linger for many weeks after delivery – and sometimes cause problems that last even longer.

Recovering from perineal tears can be challenging and painful, but with the right combination of approaches, including pelvic pain physical therapy, it can be much easier to manage.

The Basics of Perineal Tears

The perineum is the area between the opening of the vagina and the anus. It’s very common for this area to endure at least some tearing during childbirth; it’s also common for interior tissue of the vagina and other areas of the vulva to tear. In the majority of cases, these tears are routine, minor in nature, and capable of healing quickly without much intervention or ongoing treatment.

It’s also possible that you will be recommended to receive an episiotomy. This is an intentional cut into the perineum and vaginal wall, made to create more space for the baby to be born. This is a medical procedure and is only done with your informed consent; it’s generally recommended only if the baby needs to be born quickly or if the mother is at increased risk of a more serious perineal tear.

Source: flo.health

If you’ve given vaginal birth before, you’re much less likely to experience a tear, graze, or episiotomy. However, 9 out of 10 first-time mothers experience one.

Tearing is categorized based on its severity and location:

  • First degree ─ First degree tears only affect the skin. These tend to be common, relatively insignificant, and capable of healing with no further treatment required.
  • Second degree ─ Second degree tears go deeper, impacting not only the skin but also the muscle of the perineum. These tears are still common and are a bit more serious; they’re typically addressed with stitches immediately and may require some light follow-up care.
  • Third and fourth degree ─ Third and fourth degree tears are more serious, but they’re also rarer, with only 3.5 percent of women (approximately) experiencing them. Third degree tears include partial involvement of the anal sphincter. Fourth degree tears include the complete tear of the anal sphincter. These types of tears typically require repair in a full surgical procedure.

Recovering From a Perineal Tear

If you have a first or second degree tear, it will likely heal on its own without any further complications or additional treatment needed. However, it may still be very uncomfortable, or even painful for you for the weeks following your birth. If you have a third or fourth degree tear, recovery could be even more challenging, and you may require additional follow-up care.

Source: pscwomenandchildren.sg

In any case, these steps and strategies can help you recover fully:

  1. Follow all medical advice and instructions ─ First, make sure you follow all the advice and instructions of your medical professionals. They may have strict limitations on what you should be doing in the weeks following your birth, they may give you prescription medications, and they may give you instructions on how to make the recovery process easier. Take these instructions and guidelines very seriously and attend all your follow-up appointments.
  2. Sit on a pillow or padded ring ─ Sitting can be uncomfortable, or even painful, especially in the first few days following birth. One way to remedy this is to sit on a pillow or a padded ring. It’s a way to softly distribute pressure without making matters worse.
  3. Use cooling ─ Many women find that cooling is one of the best pain relievers. You can attempt to cool the wound with a padded ice pack or even a chilled witch hazel pad that sits between a menstrual pad and the site of the injury.
  4. Make strategic use of warm water while urinating ─ Unfortunately, urinating can be painful for many women who have experienced a perineal tear. One way to alleviate pain during this specific activity is to spray a gentle stream of warm water around the injured area.
  5. Take sitz baths ─ Warm water is also useful in the form of a sitz bath. The idea here is to create a bath with just enough warm water to cover your buttocks and hips. Then, sit in the bath for around five minutes. A few of these sessions throughout the day can significantly relieve your pain; additionally, you can use cool water if you find it more of a relief.
  6. Use OTC pain relievers ─ The most responsible way to address your pain with medication is to use over the counter (OTC) pain relievers, following all advisements and recommendations closely. Pain relievers like ibuprofen and acetaminophen can help you through your toughest days following birth.
  7. Consider laxatives/stool softeners ─ Bowel movements can also be painful when you’re still recovering from a perineal tear. One way to manage this is to use a laxative or a stool softener to make bowel movements easier to pass.
  8. Avoid sex, tampons, and menstrual cups ─ As your healthcare team has likely already told you, you should avoid sex, tampons, and menstrual cups until the area has fully recovered.
  9. Pursue physical therapy when you’re ready ─ Pelvic physical therapy can help you with a wide variety of symptoms you may experience after birth, such as incontinence, pelvic pain, and more. If you want to facilitate faster recovery, reduce pain, and help get your body back to normal, consider pursuing pelvic floor physical therapy; you could see a meaningful difference after just a few weeks. Ask your doctor if physical therapy is right for you.

Source: lancastergeneralhealth.org

New mothers are typically advised to create a follow-up appointment for a medical checkup between two and three weeks after the baby is born, with another checkup after six weeks. If you have any vaginal or perineal tearing, your healthcare team will examine it during this time and make further recommendations. Of course, if you experience any abnormal symptoms like severe pain, worsening pain, incontinence, or fever, it’s important to contact your healthcare team right away.

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