FFHQ Pregnancy Expert and Midwife Avril Flynn discusses the best way to care for stitches after vaginal birth.
A very common question and concern I get from new mums is how to care for their stitches.
When you give birth vaginally, many women will have some degree of tearing or they may have had an episiotomy (a small surgical cut to the perineum to help deliver their baby). Vaginas and perinea are amazing for many reasons, one of which is their ability to heal from birth- they are simply incredible.
Depending on what type of tear (or with an episiotomy) it may be necessary for the midwife or doctor to apply stitches to the area to ensure that it heals properly. With some minor tears, stitches might not be necessary at all.
An important thing to say, and I would always advise, is that all pregnant people would undertake perineal massage during pregnancy.
Perineal massage has been proven to significantly reduce your risk of tearing or the severity of the tear if you do have one. Prevention is better than cure. All that being said, there are some simple things you can do to help you heal and prevent you from running into difficulty.
With all the stuff that goes alongside caring for a newborn, sometimes personal hygiene might seem like a luxury! Especially when you are trying to juggle feeding, changing and getting some much-needed rest. But with perineal or vaginal stitches, it is essential that you keep the area as clean as possible to prevent infection.
You should change your pad frequently and clean the area a few times a day with plain water. A good tip is that urine can be acidic and stingy when you go to the loo, so take a jug or small clean bottle with you, filled with water, and as you sit on the loo pour it down over your vagina. This will take the sting away and also help keep the area clean.
There are products on the market such as sprays to encourage healing, but always make sure they are suitable to use on stitches. Modern stitches are dissolvable. They disappear gradually over a period of about 2 weeks. This allows your tissues to knit back together and the area to heal.
However, using products such as soaps or shower gels on the area can break the stitches down too quickly. Absolutely shower or bathe at least once a day but avoid using any products. Plain old water is sufficient. If you are using anything in your bath such as essential oils or salt, ensure that you get proper advice from your midwife or public health nurse to see if they are suitable to use with your stitches. You should be healed completely by 4 weeks or so.
Regardless of whether you had a drug free labour or an epidural, if you have stitches (or even if you don’t) make sure you have adequate pain relief postnatally.
Some pain medications are safe to take while breastfeeding, so if regular paracetamol is not doing the job, then seek the advice of your GP or lactation consultant to make sure you are comfortable.
Getting as much rest as possible, making sure you are really well hydrated and eating a diet rich in protein and nutrients will also help you heal.
Being adequately hydrated and eating the right food will also ensure you avoid becoming constipated. Constipation can not only be painful but puts added unnecessary pressure on your healing perineum.
Wear clothes that are not going to irritate, rub or be uncomfortable for you. Wear the biggest cotton ‘granny pants’ you can find and if you find sitting uncomfortable, either use a peri-pillow (similar to a small swimming ring that takes the pressure off your bum) or even better, just lie down!
Even with the best care in the world, sometimes problems occur. A really good idea, even if you are squeamish, is to get a mirror and check the area daily (or get your partner, your midwife or public health nurse to do it if you can’t or won’t!). Having a proper look is the best way to notice early on if there is an issue.
If you notice any smell, any gaping of the stitches, feel a sudden intense pain, feel that your pain is increasing and not improving or see fresh bleeding from the stitches, then get seen as quickly as possible.
So don’t suffer in silence if you are in any way concerned and never ever be embarrassed; I promise you, we medical professionals don’t bat an eyelid. Catching a problem early means it is far easier to treat and get you back on the road of healing and recovery.