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Stitches after vaginal delivery are very common, and most first-time moms may have to experience this. Obstetricians reveal that a light tearing of the vaginal wall usually takes place during vaginal delivery, and stitches are required to prevent further tearing and to keep infections at bay.
The stitches are usually sore in the beginning, and they may begin to itch as they start to heal. It’s important to take a little extra care after delivery so that the stitches do not get infected and cause complications. After a vaginal delivery, the vagina is generally painful and swollen. Thus, proper care is essential to help the vagina recover and for the stitches to heal completely.
Why Do You Need Stitches After Childbirth?
At the time of delivery, the baby travels through the birth canal or vagina. Although this area is stretchy and can expand to accommodate the baby’s size, a baby may require more space. When this happens, the perineum (the area between the anus and vulva) may enlarge beyond its capability and endure some tears in the process. Some tears are superficial and may heal naturally. However, sometimes, there may be tearing of the muscle tissues, and that may lead to substantial bleeding and significant pain. Therefore, they may require stitches.
In some cases, women may have to undergo an episiotomy. An episiotomy is a surgical incision made at the perineum to widen the opening in order to help the baby pass through easily and to avert the tearing of tissues at the time of delivery. In such cases, stitches are required as well.
When Does a Tear Need Stitches?
Tearing of tissues commonly occurs during delivery, especially in the case of first-time mothers. Tears may differ in severity. Tears can be largely divided into four classes:
- First-degree tear: These tears can be so minor that they heal on their own without any treatment. They are superficial as they involve the tearing of the skin of the perineum and the outer layer of the vaginal opening. They often require no stitches and heal rapidly.
- Second-degree tear: These tears run deeper, extending down to the muscles below the skin. These require stitches through the layers of skin. They generally heal in a few weeks’ time.
- Third-degree tear: These tears are more severe and can stretch deep through the perineal tissues and muscles, all the way down to the anal sphincter (muscle around the anus). They need stitches compulsorily and can cause significant pain for a few months. These tears can put you at the risk of anal incontinence (unintentional passing of stools).
- Fourth-degree tear: This is a serious tear that goes further deep through the muscles around the anus and the tissue beneath, all the way down to the rectum. You may require a small operation to stitch up the tear.
In some cases, a tear may ensue on top of the vagina, close to the urethra. These tears are usually very small and may require few or no stitches. They generally don’t include the muscles, hence heal very fast. They may result in discomfort while urinating.
How the Stitching Is Done
If it is a minor tear, you may be stitched in the room where you have delivered. The obstetrician, after administering a local anesthetic to numb the area, will close up the tear with a ‘running stitch’. Most of the time, dissolvable stitches are used as they are not required to be removed on healing.
Cases involving episiotomy or second-degree tears are taken care of in the delivery room itself, but since in third-degree tears the tear runs deeper than the skin, the patient is usually transferred to an operating theatre. The obstetrician may give a local anesthetic. If required, an epidural, spinal, or general anesthetic may be given, depending on the degree of damage. However, this is rare. That is followed by the stitching of the perineum. A thin tube (catheter) may be put into the bladder to empty out the urine. This will enable the perineum to heal quickly. Usually, episiotomy stitches are absorbable or dissolvable sutures.
How Long Does It Take to Heal?
The time taken for vaginal delivery stitches to heal is generally less, especially if good care is taken. The healing procedure usually takes 2-3 weeks after delivery in the case of a normal episiotomy, which involves a small incision. But this process may vary from person to person. The larger the tear, the longer the healing time. The pain may reduce after a week but the discomfort may continue for a month or so.
A more serious tear that involves deeper stitches may take 6 to 8 weeks to heal entirely. The pain may continue for about a month. The stitches often begin to itch around the time they start healing. It may be a good idea to schedule a checkup with the doctor at around 6 weeks to monitor the progress of the stitches.
How Can You Soothe the Tender Area?
Stitches can be fairly painful after a vaginal delivery. Certain things that can be done to soothe them are:
- Sitting in a tub of lukewarm water may not only help soothe the sore stitches but also ease the swelling. Keep in mind to gently pat the area dry later on with a soft, clean towel. Alternatively, a cold compress or a gel pack can also be used.
- If you are experiencing pain while sitting, you can try looking for ring-shaped inflatable pillows that are specially designed to offer comfort while sitting.
- To relieve pressure from your perineum while passing stools, gently press a clean pad over the stitches.
- If you feel discomfort while peeing, you may find putting warm water on the area useful in easing the burning sensation.
- Bear in mind to keep the perineum and vaginal area clean and dry to prevent an infection.
- You may opt for safe painkillers to deal with the pain, but it is advisable to first consult a doctor in this respect.
Tips to Recover Faster
Here is a list of tips that can help you recover faster:
- Strictly use an antiseptic cream prescribed by your doctor.
- Remember to wash the vaginal area with water every time after urinating, and clean your bottom carefully from front to back.
- Exposing the stitches to fresh air every day for 10-15 minutes may help them dry faster.
- Bear in mind to clean the stitches with warm water and non-perfumed, gentle soaps.
- Soaking in a tub of warm water for 15-20 minutes a few times in a day can prove helpful in easing the pain. You may add in some antiseptic lotion to the warm water if you desire.
- Include a lot of fibre in your diet, have balanced meals, and drink plenty of water to prevent constipation.
- You can go for over-the-counter stool softeners so as to make your bathroom process less stressful on your stitches. However, make sure to consult your doctor before doing so.
- It may be sensible to use Western-style toilets instead of Indian style ones so as to avoid exerting unnecessary pressure on the stitches.
- Taking regular short walks and doing certain pelvic floor exercises can aid in boosting blood circulation which may quicken the recovery process.
- It is essential to wash your hands properly after using the toilet and before changing your maternity pads to prevent the infection from spreading.
- Refrain from lifting heavy weights and doing strenuous exercises to avoid exerting pressure on the stitches.
- It is important to maintain proper personal hygiene by keeping the vaginal area dry and clean to reduce the risk of possible infections. It is best to frequently change maternity pads and take care that they don’t irritate the sore stitches.
- Some things to strictly avoid during your recovery: salt baths, sexual activity, usage of tampons, scented soaps and body washes, talcum powders, or extremely hot water in the area.
Can You Avoid Having Stitches?
Most doctors may like to go for an episiotomy for normal delivery, particularly in the case of first-time moms. Still, if you wish to avoid having stitches, it is best to discuss your options with the doctor at length.
There may be certain things that can be tried to reduce the possibility of a severe tear during delivery – gently massaging the perineum daily during pregnancy, or applying a warm compress on the perineum at the time of labour. You can also ask your prenatal instructor to teach you proper squatting and pelvic floor exercises or yoga to strengthen the pelvic muscles and enhance skin elasticity.
Will It Cause Problems in the Future?
It is important to know how to take care of after-delivery stitches properly so that they heal safely and completely. Some women may experience pain during intercourse. In such a scenario, it is best to wait a while and let the stitches heal properly. In some cases, women may be troubled with continued perineal pain and difficulty in regulating stools or urine. Whatever may be the problem, it can be prevented by taking good care of your health, eating healthy and exercising regularly. If the problem still persists, seek appropriate medical help.
When to Consult Your Gynaecologist
Despite good care, certain complications may sometimes arise with stitches. It is advisable to consult your gynaecologist in case you experience the following:
- Constant and severe pain in the stitches area
- Foul smell from the vaginal area
- High fever and chills
- Intense burning sensation while urinating
- Lack of control over bowel movements
- Uncontrollable bleeding, especially clots
- Excessive redness or swelling of the stitches
- Unusual discharge from the stitches
It is not difficult to understand why many women may like to avoid having stitches at the time of delivery. But some tearing of tissue during childbirth is inevitable and is considered a usual part of the entire process of birth. The important thing is to take sufficient rest and stay healthy to help recover faster and to heal completely.
