Taking Care, Management and Recovery from Perineal Tears

The perineum is the area located in between and separating your anus and vagina. During labor or childbirth, the strain of the baby coming out of the birth canal and the inability of the vagina to stretch around it can cause the tearing or laceration of the perineum.

This relatively common and painful condition is called vaginal or perineal tears or lacerations. Almost 50% of all women suffer from at least the first or second degrees of tearing during childbirth.

Different severities of the tear require different lengths of time to heal, which can take a few weeks to several months. Fortunately, there are ways to relieve the pain and hasten the healing process. Know more about these in the next sections.

Degrees of Vaginal or Perineal Tears

There are four degrees of vaginal or perineal tears depending on the severity and extent of the tear.

  • First-degree perineal tear

First-degree tears happen when only the perineal skin is torn and leads to a mild burning sensation or stinging feeling when urinating.

  • Second-degree perineal tear

Second-degree tears involve some or all of the perineal muscles. These muscles help the pelvic floor muscles support the bladder, rectum, and uterus. These usually need stitches and start to heal within several weeks.

  • Third-degree perineal tear

Third-degree tears not only involve the tearing of the perineal muscles, but also the surrounding muscles of the anal sphincter or anus. This type of tear require an operation to repair and may take months in order to heal.

It can lead to complications like painful intercourse and faecal incontinence.

  • Fourth-degree perineal tear

Fourth-degree tears involve tearing of the anal sphincter, the perineal skin and muscles, and the tissues that line the rectum. This also requires operation and healing might take several months.

Painful intercourse and faecal incontinence are also possible complications.

Depending on your rate of recovery and the degree of your perineal tear during your postpartum checkup, your OB-GYN or health care provider may refer you to other specialists like a colorectal surgeon or a urogynecologist.

Tips for Perineal Tears Management and Care

In most cases, vaginal tears that are longer than an inch or 2 cm require stitches. Because of this, tenderness in the area may be experienced as it heals.

Similar to any freshly repaired wound, it will take time, maybe around 7 to 10 days for the site to heal, but the wound will hurt far longer than that.

So, it is important to take it easy and take care of the wound to avoid infections and the need to redo the stitches. Observing the right hygiene can also alleviate the pain and promote faster healing. Here are ways on how to take care of your perineum:

  • Squirt warm water on the perineum and vulva during and after urination.
  • Wash your perineal area after each bowel movement.
  • Do not rub but pat dry the area from front to back using paper wipes or gauze pads.
  • Do not use a hairdryer to dry the area.
  • Replace your maxi pad every four to six hours.
  • Avoid touching the area.
  • Strive to keep your bowel movement regular. To help things to move along, eat a fiber-rich diet including fresh vegetables and fruits. Drink plenty of fluids.
  • Try to stand up and walk around or go for short walks once you feel ready to do so.
  • Ask your doctor about a mild laxative or stool softener.
  • Avoid using any powder, creams, or ointments unless otherwise advised by your doctor. Apply ice packs on the perineal area about every couple of hours for at least one to two days. Chilled witch hazel pads, a maxi pad with a cold pack, or a surgical glove filled with crushed ice also work.
  • Take pain relievers as prescribed by your doctor.
  • Rest and lie down for at least 20 to 40 minutes per hour to allow the area to heal.
  • Feed your baby while lying down or in a sitting position.
  • To reduce strain and pressure on your perineum, get in and out of bed on your sides.
  • Take a warm sitz bath for twenty minutes thrice a day or use a warm compress. With your physician’s go signal, you can also try a heat lamp.
  • For severe pain, your doctor may prescribe or recommend a numbing anesthetic spray, pad, or ointments.
  • Sitting on a doughnut-shaped pillow or cushion or a padded ring advertised for hemorrhoid patients can also give you comfort especially if you do suffer from pregnancy hemorrhoids.
  • Do Kegel exercises before your due date and after delivery to stimulate circulation and healing.
  • Call your doctor if you notice any swelling, redness, or unpleasant odor.

Follow these tips so you can heal your perineal tear as soon as possible.

References:
http://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/multimedia/vaginal-tears/sls-20077129?s=1
https://www.whattoexpect.com/first-year/perineal-tears/
http://brochures.mater.org.au/brochures/mater-mothers-private-redland/recovering-from-3rd-or-4th-degree-perineal-tears

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