During childbirth, your pelvis and your internal and external sexual organs are subjected to great pressure, stretching and force. This can, but does not necessarily, result in birth injuries such as a perineal tear, abrasions on the labia and vulva or tears in the vagina. Sometimes the perineum is cut during birth to make birth easier for the baby. However, this practice is now usually only used when absolutely necessary because injuries caused by tears usually heal better than artificial cuts with smooth edges.
The perineal tear
When the baby comes out of the vulva, the tissue between the vulva and the anus, the perineum, is greatly stretched. This can cause it to tear. This usually happens at the weakest point, which is directly at the lower end of the vulva, so that the perineum tears vertically towards the anus. A perineal tear can have different degrees of severity, which indicate whether only the skin and subcutaneous tissue have been injured (grade I), whether the perineal muscles themselves have also been torn (grade II) or, although this is more rare, whether the anal sphincter (grade III) or the mucous membrane in the rectum (grade IV) have also been torn. Third-degree perineal tears occur in around three to five percent of births in Germany, and fourth-degree tears only occur in one in a thousand births, with both injuries often being associated with births in which a vacuum extractor or forceps were used.
In some cases, perineal tears that only affect the skin and subcutaneous tissue are not sutured and are left to heal on their own. In the case of deeper tears, a layered suture ensures that the individual tissue layers grow together properly.
Abrasions on the labia and tears in the vagina
The stretching caused by the passage of your baby's head and shoulders through your vagina and vulva can not only cause your perineum to tear: so-called abrasions can also occur on your labia, in your vagina or on your cervix.
Abrasions on the inner and outer labia as well as tears in the vagina rarely need to be stitched, but usually heal quickly on their own. Rare cervical tears (injuries to the cervix, which occur in about one in two hundred births) are stitched after birth.
What is the best way to heal my birth injuries?
Birth injuries occur in many births and in most cases heal to a large extent in the early postpartum period, i.e. in the first ten days after birth. To help a perineal tear or episiotomy, as well as tears in the vagina and abrasions on your vulva, to heal, you should - if at all possible - avoid stretching and straining the tissue on the perineum and vulva as much as possible.
In the first few days of the postpartum period, the injuries can also cause a burning sensation when peeing. This is caused by the acidic urine coming into contact with the open wounds. An intimate shower with lukewarm water can provide relief. This solution can be poured over the vulva when urinating so that the urine is diluted and the wounds are no longer irritated as much. Alternatively, you can also pee in the shower and carefully shower lukewarm water over the vulva.
You can also cool the injuries on your vulva with a the weeks organic postpartum pad - on ice (ice bandage): Simply place a pad slightly moistened with water or recovery spray in the freezer. After a few hours you can take it out again, put it in a cloth or disposable glove and place it on your vulva. Lots of air is also good for the healing wounds.
Rinses can also have a soothing effect on your injuries: To do this, mix a tincture of water and the Recovery Spray . You can pour this rinse either when you urinate or directly over the vulva afterwards. You can also take a short sitz bath in a lukewarm solution. If you don't have a suitable container for this and don't have a bathtub, this simple trick might help: pull a plastic bag over the seat of your toilet so that you can catch a small puddle of water in it. Now pour some of the lukewarm Recovery solution into this plastic bowl and simply sit on the toilet seat.
Healing your vaginal injuries, such as abrasions on the vulva or tears in the vagina and perineum, can cause mild itching and also feelings of tension. However, if this is accompanied by an unpleasant smell or even a whitish, crumbly discharge (if you can see it under the lochia), there could be a fungus behind it that should be treated. It is best to contact your postpartum midwife or gynecologist to discuss suitable treatment options during the postpartum period.
Can my perineal suture come undone if I have a solid stool?
No. But let's start from the beginning: If you had a bowel movement before and/or during the birth, it is not a cause for concern if you haven't been to the toilet on the second day after. On the third day, however, things should slowly start to move, say the midwives. And to make your stool particularly soft, you can use the following foods in addition to high-fiber foods: In addition to the classics linseed and psyllium husks, natural yoghurt and pears can also help loosen the stool. And of course, drink lots and lots and lots of fluids.
When the time comes and you feel the urge to go to the toilet, definitely give in and don't put it off. Nothing can happen to your perineal suture, I promise. And although it really doesn't feel like it often, you can trust the opinion of all the midwives we know on this point without worry. If it still feels particularly bad for you, it can help to hold your perineum with a warm washcloth while you go to the toilet.
