If you have a deep tear or episiotomy (controlled cut) you will have received vaginal stitches after birth. Learning how to care for your stitches will help you to heal quickly and well. Stork Mama has created this guide to inform you of everything you need to know about caring for your stitches. We’ll discuss which products you should stock up on and any questions you may have. First, let’s discuss the basic care of vaginal stitches.
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Vaginal Stitches after Birth – Ultimate Care Guide
1. Self Care
Whether you have had stitches or not, hand washing is important after delivery. It prevents the spread of infection, which happens fast with open wounds. You will be dealing with a lot of blood, poop and vomit in the first few weeks so your hands get dirty quickly. A simple hand wash before and after each trip to the loo will reduce your risk of infection in your stitches.
The thought of cleaning your stitches can make you anxious. They are already sore, and you don’t want to irritate or pull at them. Check out our tips for keeping your stitches clean:
It is recommended you clean your stitches daily. Your vagina has a fine balance of pH and bacteria to keep it healthy. Washing with harsh soaps can disturb this delicate balance. It is recommended you wash your stitches with plain or salted water only until they heal. You don’t need to touch the stitches, to clean. Simply sit in the bath water, sitz bath or use a spray down with a slow water flow from the shower.
Pat drying is recommended to remove excess water after washing. Do not rub the stitches as toweling material can easily catch and pull them. Drying with an old cotton t-shirt is a great way to avoid snags. Give your vagina as much chance to air dry as possible during the day. This will allow air to circulate and improve the healing process.
Do not douche your vagina for at least 6 weeks after delivery. Even if you’re perineal stitches have healed as your vagina and cervix may become irritated.
Avoid using any perfumed toiletries until the stitches have healed. This includes creams, lotions or perfumes. The chemicals can cause itching or irritation to the area. Medical products or specialized perineal products can be used. These will be tested as safe for use and can help encourage healing.
You will bleed for up to 6 weeks after delivery. You’ll have to use sanitary towels to catch the blood loss or ‘Lochia’. This type of bleeding should not be treated as a normal period.
Maternity pads are the best option for postpartum bleeding. Let’s look at the two options and how they can affect your stitches.
- Disposable Pads – These pads are for single use only. They are great for hygiene, convenience, and absorbency. The drawbacks are that they are made of plastic, prevent air flow and have a tendency to rub stitches.
- Reusable Pads – You can wash these pads and use again. These pads are breathable, comfortable, and don’t irritate stitches. The biggest drawback is the regular washing. We would recommend reusable pads over disposable if you can put up with the extra task.
- Tampons – Never use these for postpartum bleeding. They greatly increase your risk of infection after birth. You also cannot monitor your bleeding as easily as pads.
Postpartum bleeding needs to be monitored for signs of infection, clots or excessive loss. This means you’ll need to change your pads regularly. Every 2-3 hours is the average for most women; however, sooner if they are heavily soiled. Any excessive bleeding, clots or offensive smells should be reported to your caregiver as soon as possible.
Opt for loose clothing made from breathable fibers, especially underwear. This will help the airflow to the vagina. Underwear should be changed daily or when soiled. Smooth materials such as cotton are less likely to pull on stitches, are anti-bacterial and promote airflow. For sleeping, nightgowns are preferable to pajama bottoms to prevent friction or irritation.
Keeping pressure from the stitches will reduce swelling and encourage healing.
- Rest – In the first-week rest as much as possible. Your body needs to conserve energy to recover. Try to sit down gently and lie on your side. Elevating your feet with a pillow can improve circulation to the stitches.
- Mobility – When your energy levels begin to return, you can begin to move around more. Prolonged sitting puts a lot of pressure on the vaginal area and can increase pain. Keeping mobile also improves circulation and prevents blood clots, especially if you’ve had an instrumental delivery.
- Exercise – You probably won’t feel up to doing too much. Gentle exercises are encouraged, such as walking or yoga. Avoid exercises such as weightlifting, cycling, horse riding or squatting, which put pressure on the perineum. All of these can increase pressure on the stitches, which can slow the healing process.
Your stitches should not be painful; however, they can be uncomfortable, tight or itchy. Try these tips to get some relief.
Over The Counter
Regular painkillers such as Tylenol or Advil will give you pain relief and reduce the swelling. Try to avoid codeine based pain relief as this can make you constipated. Numbing sprays are also ideal for quick targeted pain relief. If you require stronger painkillers for severe discomfort, you may need your stitches reviewed for signs of infection.
If you prefer to avoid over the counter based medication, you can use homeopathic remedies. Some favorites for perineal care are:
- Witch Hazel – The healing properties include relief for swelling, itching, bleeding, and pain. You can see why witch hazel is a favorite to use after birth. You can buy astringent pads to wipe with or add a few drops on to your maternity pads.
- Aloe Vera – Known for cooling skin and relieving swelling. Try adding some organic aloe vera gel to your maternity pads to sooth the area all day long.
- Lavender – Add a few drops of oil to your bath or sitz bath. Lavender is known to help the swelling, preventing infection and relaxation.
- Arnica – Well known for its ability to reduce bruising, swelling and pain. Take these in tablet form or use as a gel on your postpartum pads.
- Cold – Most women find that keeping the area cold provides a lot of relief. Ice packs or pads help reduce swelling and prevent stitches feeling tight and itchy. Keeping the area at a lower temperature prevents bacteria from growing.
- Heat – Occasional warm baths are great for improving circulation to the area. This helps to promote healing of the wound.
3. Intimate Issues
The thought of going to the toilet or ever having sex again can be petrifying. Everything will feel so tight, tender and uncomfortable.
Going for a pee with stitches can be a bit of a stingy experience. Increasing your fluid intake will dilute the urine. It will also help prevent you developing a urine infection which will add to your pain. Try using a perineal bottle to spray water on the area as you pee. A diaper sprayer or bidet is great for avoiding wiping with toilet paper and causing further irritation. If you have trouble with the volume, sensation or control of urine tell your healthcare provider immediately.
Most women fear their stitches bursting when they poo; however, this is rare. You won’t open your bowels for a few days after delivery. Try to avoid constipation by eating a good diet, increase fluids or using stool softeners. The best advice is to avoid straining otherwise you risk causing further swelling. A footstool is great for raising your knees above your hips and creating a natural squat position, which relaxes the bowel muscles. Try using a maternity pad pressed on the perineum for support. This will mentally stop you feeling like your insides will fall out when you go.
Use toilet paper or unscented moist wipes in a front to back motion. This prevents any bacteria from your poo from causing infection in your stitches.
Pushing during delivery or when having a bowel movement can cause you to develop piles. These are small swollen blood vessels, which cause irritation and discomfort. If you bleed when pooing make sure it’s from the hemorrhoids rather than the stitches. Creams and suppositories can be used to ease them.
It is recommended you avoid sex up to 6 weeks postpartum. Having sex during this time increases your chances of infection and can damage stitches.
- Communicate – Talk to your partner about your fear of pain when resuming your sex life. You’ll probably feel quite tense and tender the first time. Lots of foreplay can help to loosen thing up and relax you. Hormone levels can increase vaginal dryness so opt for a water-based lubricant to make things easier.
- Positions – You may want to avoid certain positions, which are too deep or affect the stitched area. Side lying and woman on top are good positions for controlling the depth and angle of penetration. If it feels painful, stop immediately or your risk causing damage to your vagina.
Pelvic Floor Exercises
Start doing pelvic floor exercises (Kegels) as soon as you can after delivery. It’s important to keep doing them regularly to keep circulation food in this area. Strong pelvic floor muscles will prevent you from experiencing urinary incontinence or a prolapse in later life. Weak pelvic floor muscles can also make sex painful or decrease sensitivity. If you had a 3rd or 4th-degree tear, a physiotherapist will usually give you specific pelvic floor exercises to do.
4. Seeking Advice
You may need some advice if you have any concerns about your stitches. An examination or personalized care plan will be required from your health care provider.
Best practice is to have a daily check of your stitches. Use good lighting and a mirror to get a clear view. The stitches should not have:
- Gaps or broken stitches
- A blood-filled lump
- Oozing pus
- Excessive redness
- Feel hot to touch
If you notice any of these signs or they are combined with pain, excessive swelling, an offensive smell or fever get immediate medical attention. These are signs of infection, which needs to be treated immediately with antibiotics.
If you feel your stitches have not healed properly discuss this at your postpartum check-up. Common symptoms include pain from the site, pain when urinating, repeat infection or painful sex. Your stitches may require re-suturing.
For severe tears (3rd and 4th degree) you will need to attend regular follow-up appointments. This will include advice from a team of professionals such as gynecologists, urology, physiotherapists, dieticians, mental health team and sexual counseling. They will develop a care plan to help you cope with the long-term effects of a severe tear, which can be life-changing.
12 Perineal Care Products You Need
Looking to make a quick recovery after delivery? We’ve gathered a list of products you should stock up on if you have vaginal stitches. These products are designed to aid vaginal healing, tackle discomfort and prevent wound infection.
1. Cooling Pads
Keeping the perineum cool can help reduce painful swelling of the stitches. Pick up some specialist gel pads which are soft and provide cooling relief to the vagina. You can also make your own by soaking and freezing regular maternity pads.
2. Cooling Spray
Having a cooling spray to hand can provide you with instant relief. Other relief methods such as bath are not convenient when you are on the go. Keep a small spray bottle in your handbag or change bag and always be prepared.
3. Hemorrhoid Relief
Vaginal delivery often results in hemorrhoids. These can add to the pain or irritation of stitches. You can opt for hemorrhoids treatment in cream, suppository of spray formulas. Remember not to stain when doing a poo, as this can cause them or make them worse.
4. Pelvic Floor Trainer
Start your Kegel exercises as soon as you can after delivery. This will strengthen your pelvic floor muscles to improve your recovery after birth. A cut or tear will weaken these areas and can lead to future health issues such as incontinence, prolapse or painful sex. A pelvic floor trainer can be used 6 week postpartum to advance the strengthening of your pelvic floor muscles.
5. Maternity Pads
You will need maternity pads to absorb your bleeding after delivery. Your blood loss can tell you if you need medical help or show signs of infection. They can also provide cushioning or help keep soothing gels or cooling pads close to your stitches. Read our recommendations for the best maternity pads here.
6. Pain Killers
Birth tends to leave to feeling sore and stitches will add to the pain. Regular mild pain killers such a paracetamol or ibuprofen is great for tackling the pain. Keep these on hand for when you feel your stitches becoming uncomfortable. If the pain persists arrange for your caregiver to inspect your stitches.
7. Perineal Bottle
We recommend spraying water on the vagina as you pee to reduce the stinging sensation. Using a perineal bottle in an inexpensive way to do this. It also means you won’t need to wipe with rough, dry toilet paper. If you practically shower after every toilet trip why not opt for a toilet bidet unit.
8. Perineal Cushion
A donut cushion is ideal for relieving pressure from your perineum when sitting. Stitches increase swelling, which worsens with extra weight. The cushion elevates the body and leaves the perineum free. These cushions are also great for hemorrhoids or tailbone pain after delivery.
9. Sitz Bath Soak
A sitz bath is a shallow bath used to soak only the perineal area. It helps you to improve hygiene and provide relief as your stitches heal. A sitz bath soak is a specialist product with natural ingredients to reduce perineal swelling and discomfort.
10. Stool Softener
You probably won’t poo until around 3 days after delivery. Having stitches can increase the fear of your first poo after birth . Get ahead of the game and start using a stool softener to prevent constipation when the time comes. Remember to combine it with a good diet and lots of water to get your bowel moving.
Opt for cool, cotton based postpartum underwear. This allows your stitches to breathe to promote healing. The fabric should be smooth to prevent snagging or pulling at stitches. Some women even opt for disposable maternity pants to wear during the first week after delivery. Click here for our top postpartum underwear picks.
12. Witch Hazel Pads
We already know that witch hazel is perfect for perineal healing. It helps with swelling, bleeding and reduces pain. Tucks witch hazel pads are great for using as a soft wipe after the toilet. You can also keep them on top of your maternity pad for ongoing cooling relief.
Related: How to Prevent Pooping During Birth
Vaginal Stitches After Birth FAQ
How long do stitches take to heal?
Stitches will dissolve by 10 days postpartum. It can then take your body up to 6 weeks to fully recover from the tear or cut. Depending on the extent of your cut or tear you may take up to 6 months to feel ‘normal’ down there.
Will I tear with my next baby?
Not necessarily. First time moms are more likely to tear than moms who have already given birth. The skin is more stretchy and supple after your first labor. You may want to try a perineal massage in the later stages of your next pregnancy.
What if my stitches won’t heal?
Sometimes stitches don’t fully dissolve and need to be removed. If your wound isn’t healing it may be a sign of infection. Depending on the severity of your tear it can take a long time to heal. If you have concerns about your stitches discuss them with your doctor or midwife. You may require surgical input to rectify the healing of your pelvic floor.
How soon can I go swimming with vaginal stitches?
It is advisable not to go swimming in a chlorinated pool for up to 6 weeks post-delivery. The chemicals can increase your risk of infection. However, you may wish to discuss this with your healthcare provider before your discharge home.