This came as a bit of a shock ladies…. I really don’t think I had truly considered what the after-effects might be of pushing a baby out of my vagina followed by 5 "small" stitches to get things back in shape. The stitches actually and amazingly were almost an afterthought after giving birth but then came my first visit to the bathroom which stung like hell.

Why had no one told me there were things like Sitz baths and little squirty bottles available at the hospital to help with this discomfort? i don’t want to overdramatize matters but my vagina, along with every other cell in my body, felt like it had just won first place in a marathon. But when I padded myself dry after a bath, or tried  to wipe my bottom, it felt all puffy and swollen and it took me about a month to actually pluck up courage and take a look.

The babycenter.com writes, "In general, the deeper the cut or tear, the longer the recovery time. A small laceration ("first degree") doesn’t involve any muscle, and it may not even require stitches. These tears generally heal quickly and cause little discomfort. A typical episiotomy or second-degree tear usually heals in two or three weeks (the stitches dissolve on their own during this time). Some women feel little pain after a week or so, while others have discomfort for a month or so." I think I must have been in the second camp… and I must remember to ask my midwife what approximate percentage of her patients end up having stitches, because I have a feeling this blog applies to the majority of women.

Here are some usful tips provided by the babycenter.com to help with the pain:

• Right after birth, apply an ice pack with a soft covering to your perineum. (Your nurse will probably give you one before you have a chance to ask for it.) This will help reduce swelling and discomfort. Ask for a new ice pack every few hours over the next 12 hours or so.

• If you have an extensive tear and your caregiver gives you a prescription pain reliever, don’t hesitate to take the pills — they’ll make the pain much more bearable. Once you’re feeling a bit better, you can take over-the-counter ibuprofen or acetaminophen. (Don’t take aspirin if you’re breastfeeding.) You may also want to use an anesthetic spray for the first couple of days. But ladies, I would hesitate before going down this road. If you are breastfeeding, all those drugs aren’t great for your baby… take a look further down on this blog where I have some natural bath remedies to help with the pain.

• Change your sanitary pad every time you use the bathroom. I haven’t talked yet about the bleeding but I had a lot of bleeding - and if you start picking things up too quickly you will bleed even more - but you will need to change your pads regularly to keep the perineal area clean.

• Use the squirt bottle ("peri-bottle") provided by the hospital to pour warm water on your perineum while you’re going to the bathroom. The water dilutes your urine so it doesn’t burn as much when it comes in contact with your skin. Cleanse yourself with another squirt afterward.

• Pat yourself dry from front to back to avoid introducing germs from the rectum into the vaginal area.

• Try not to sit for long periods of time while your bottom is still very sore.

• Twenty-four hours after you give birth, you can start taking warm soaks in the tub or in a sitz bath for 20 minutes three times a day. A sitz bath is a shallow plastic basin that you fill with warm water and position over your toilet seat. It makes it convenient to soak your bottom several times a day without having to fill a tub full of water and completely undress each time. Most hospitals will provide you with a sitz bath to use while you’re there, and it’s a good idea to take it home with you. Sitz baths also are available at most drugstores.

• Apply compresses of cotton pads soaked in witch hazel to the affected area.

• Expose the wound to air as much as possible.

• Begin doing Kegel exercises the day you give birth to help restore muscle tone, stimulate circulation, and speed healing. Try doing a Kegel while changing positions or getting up from a bed or chair. This helps to support the wound so you’ll feel less of a pulling sensation on your stitches when you move.

• If you have a tear that involves your anal sphincter (third- or fourth-degree), drink plenty of fluids. Start taking a stool softener right after you deliver and continue for a few weeks. Avoid all rectal treatments, such as suppositories or enemas.

• Take it easy and don’t take on any unnecessary chores. Save your energy for taking care of your baby and yourself so your body has time to heal.

• Consult your caregiver if you’re not finding relief or if you have increased pain or swelling. Also call if you have any fever, which can be a sign of infection

I also took at a look at Aviva Romm’s wonderful book "Natural Health After Birth" and she recommends a Deep-Healing bath (strongly astringent and antiseptic) which is perfect for healing trauma to the perineum, including tears and episiotomies. She says you can start to take a bath as soon as an hour after birth, then repeat once or twice daily for 3 to 5 days. I think this all comes down to the individual, I don’t think I was ready to get into a bath for at least 24 hours.

1 ounce of dried comfrey leaf

1 ounce of yarrow blossoms

1 ounce dried sage leaf

1 ounce dried rosemary leaf

1 large fresh bulb of garlic

1/2 cup of sea salt

In a medium bowl, mix together the comfrey, yarrow, safe and rosemary. Peel all the garlic cloves and place them in a blender with 2 cups of lukewarm water. Blend at high speed until you have a milky liquid and the garlic is completely pulverized. Strain through a fine=mess strainer. Bring 6 cups of water to a boil, then turn off the heat. Add 1 ounce of the dried herb blend to the pot and steep for 30 mins. Strain the liquid and discard the herb material. Pour 1 cup of the garlic "milk" and 4 cups of the herb tea into the bath, along with the salt. Reserve the remaining liquids for a subsequent bath.

CAUTION: Do not use the garlic milk in a peri bottle or compress - it would be too irritating. The tea, however, is safe to use in the bath.

For an herbal compress: Simply soak a washcloth in the herbal tea and apply warm or cold to the perineum, as needed, to reduce tenderness and swelling.

For a peri-rinse: Purchase a peri bottle, a plastic squeeze bottle, from any pharmacy and fill with the strained tea of your choice. Use warm or at room temperature. Squeeze over your perineal area as you urinate. This significantly reduces inflammation and stinging.

And finally….. because not everyone has profound discomfort but still deserves an uplifting, soothing, healing and antiseptic bath, Aviva recommends the Postpartum Delight bath (you can also let your baby accompany you as it promotes healing of the umbilical site although many people prefer not to bathe their babies during the first week or so - but PLEASE mind the temperature of the water).

2 ounces comfrey leaves

1 ounce calendula flowers

1 ounce lavender flowers

1 ounce sage leaf

1/2 ounce myrrh powder

3/4 cup sea salt

Mix together the comfrey, calendula, lavender, sage and myrhh. Bring 4 quarts of water to a boil. Turn off the heat and place 1 ounce (approx 1 large handful) of the mixture into the pot. Steep, covered, for 30 minutes. Strain the liquid with a fine-mesh strainer and discard teh herb material. Add 2 quarts of the liquid to the tub, along with the salt. Reserve the remaining liquid for another bath, for compresses, or for a peri bottle.

You might also like to add a little after-birth massage oil which can also bring great relief (again we have to thank Aviva for this recipe):

3 ounces almond oil

1/2 ounce arnica oil

1/4 ounce essential oil of rosemary

1/4 ounce essential oil of wintergreen

Mix well in a small plastic squeeze bottle and store in a cool, dark place. Apply as needed, shaking well before use.

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November 20th, 2006 | Permalink