Stitches after normal delivery: how to care and heal
Stitches are usually painful to begin with, and the area may begin to itch as it begins to heal. A little extra care is needed at this time, so that it doesn't get infected and cause complications later on. After a normal delivery, there is usually pain and swelling. Thus, sutures are required for vaginal recovery and complete healing and proper care is essential to help this.
Why does your baby need stitches after birth?
During delivery, the baby passes out through the birth canal or vagina. Although this area is expandable and can expand according to the size of the baby, sometimes the baby may need more space. When this happens, the perineum (the area between the anus and the vagina) can exceed its capacity and tear a bit in the process. Some tears are not too deep in the skin and can heal naturally. However, some tears can be severe, involving muscle tissue and causing considerable bleeding and significant pain. Therefore, they require stitches.
In some cases, women may have to undergo episiotomy. An epididymis is a surgery to widen the opening of the vagina to make it easier for the baby to come out during normal labor and to prevent tissue tearing during labor. In such cases, stitches are also required.
When does a tear need stitches?
Tissue tearing usually occurs during childbirth in first-time mothers. Tears can vary widely in severity. Tears can basically be divided into four categories:
1. First degree laceration
Some tears may be so small that they may heal on their own without treatment. They are superficial because they are only on the outer layer of the skin of the perineum and the opening of the vagina. They often require no stitches and heal quickly.
2. Second degree laceration
Some tears extend deep into the muscles beneath the skin. In this case, the skin layer needs to be sutured. They usually take a few weeks to heal.
3. Third degree laceration
Some tears are more severe and may extend deep through the perineal tissues and muscles to the rectus abdominis (the muscles around the anus). These obviously require stitches and can cause significant pain for several months. These tears can put you at risk of rectal incontinence (uncontrollable passing of stool).
4. Fourth degree laceration
This is a serious tear that goes deeper through the muscles around the anus and its tissues up to the anus. A small operation may be required to suture this tear.
In some cases, a small tear may appear above the vagina near the urethra. These tears are usually very small and may require only a few stitches or none at all. They usually do not reach the muscle, so heal very quickly. They can cause discomfort during urination.
How the stitching is done
If it's a small tear, it can be stitched up in the room where your delivery is performed. After a local anesthetic, the person will close the tear with “running stitches”, numbing the area. In most cases, dissolvable sutures are used, as they do not need to be cut out to heal.
In cases of episiotomy or second- to third-degree lacerations, where the laceration penetrates deeper into the skin than the muscle, the patient is usually transferred to an operating theatre. The obstetrician may administer a local anesthetic through an epidural (spinal) or some local anesthetic, depending on the degree of injury, and then suture the perineum. A thin tube (catheter) may be placed into the bladder to empty the uterus. This will enable the perineum to heal faster. Typically, episiotomy sutures are absorbable or dissolvable sutures.
How long does it take to heal?
The healing time for normal delivery sutures is usually short, especially if good care is taken. In the case of a normal episiotomy, usually involving a short cycle, the healing process usually takes 2-3 weeks after delivery. But this process can vary from person to person. Also, if the tear is larger, it may take longer to heal. Pain may subside after a week but discomfort may persist for a month or more.
More severe tears involving deeper stitches may take longer to heal. It may take 6 to 8 weeks to heal completely. The pain may be felt for about a month. Itching often occurs when the stitches begin to heal. It may be a good idea to schedule a checkup with the doctor in 6 weeks to monitor the progress of the stitches.
How can you soothe the painful area?
Stitches can be fairly painful after a normal delivery. Following are some things that can be done to mitigate them:
Sitting in a tub of cold water not only helps cool the painful stitches, but also reduces swelling. Remember to dry the area afterwards with a soft, clean towel. Alternatively, a cold compress or a gel pack can be used.
If you experience pain while sitting, use a ring-shaped inflatable pillow or valley cushion that is specifically designed to provide comfort while sitting.
To relieve pressure from your perineum while defecating, gently press a clean pad over the stitches.
If you feel discomfort while urinating, you can gently apply warm water to the area to ease the burning sensation.
Remember to keep the perineum and vaginal area clean and dry to prevent infection during normal delivery stitches.
You can choose safe painkillers to deal with the pain but it is recommended to consult a doctor first.
Quick recovery tips
Here is a list of tips that can help you recover faster:
Applying some lavender oil on stitches can provide pain relief as lavender oil has excellent antiseptic properties.
Immediately after urination, clean your vagina by washing it with water and carefully cleaning from below.
Daily exposure to fresh air for 10-15 minutes helps the sutures dry quickly.
Remember to clean the stitches with warm water and non-perfumed, mild soap.
Immersion in a tub of warm water for 15-20 minutes, several times a day can help ease the pain.
Include plenty of fiber in your diet, eat a balanced diet and drink plenty of water to prevent constipation.
It may be better to use commode style toilets to avoid unnecessary pressure on the toilet.
Regular short walks and some pelvic floor exercises help increase blood circulation which can speed up the healing process.
Hands should be washed after using the toilet and before changing the maternity pad to prevent the spread of infection.
Avoid heavy lifting and strenuous exercise to avoid undue stress on the stitches.
Maintaining proper personal hygiene by keeping the vaginal area dry and clean is important to reduce the risk of possible infection. Change maternity pads often and take care not to cause severe pain or itching in the stitches.
Can you avoid having stitches?
Most doctors prefer to go for an episiotomy for normal delivery, especially for first-time mothers. Still, if you want to avoid stitches, it's best to discuss your options with your doctor.
There are things that can be tried to reduce the risk of severe tearing during labor, such as massaging the perineum daily during pregnancy, applying a warm compress to the perineum during labor. You can ask your prenatal trainer to show you some yoga poses to strengthen muscles and increase skin elasticity through proper squatting and pelvic floor exercises or yoga.
Will it cause future problems?
It is important to understand how to properly care for stitches after delivery, so that they stay safe and heal completely. Some women may experience pain during intercourse. In this case, wait for some time and let the stitches heal properly. In some cases, women may experience persistent perineal pain, difficulty with bowel movements or bladder control. Whatever the problem, it can be prevented by taking care of your health, eating healthy and exercising regularly. If the problem persists, seek appropriate medical help.
When to Consult Your Gynecologist
Despite good care, certain complications can sometimes develop with sutures. It is recommended to consult your gynecologist if you experience the following:
Continuous and severe normal labor stitches.
Foul odor from vaginal area.
Fever and chills with high blood pressure.
Intense burning sensation while urinating.
Lack of control over bowel movements.
Bleeding that is uncontrollable, especially if profuse.
If there is excessive pain or swelling of the stitches.
Abnormal discharge from stitches.
It's not hard to understand why many women want to avoid stitches during labor. However, some tearing of the tissue during childbirth is inevitable and is considered a normal part of the entire birth process. The important thing is to rest and stay healthy to help heal quickly and heal completely.
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