In this Article
Stitches after normal delivery are very common and most first-time moms may have to experience this. Obstetricians reveal that during normal delivery, some tearing of vaginal wall usually takes place. Therefore, stitches are required to prevent further tearing of the wall and any likely infection. The stitches are usually sore in the beginning and they may begin to itch as they start to heal. Little extra self-care is required during this time lest they become infected and lead to complications later on. After a normal delivery, the vagina is generally painful and swollen. Thus, proper care is essential to help the vagina recover and for the stitches to heal completely.
Why Do You Need Stitches After Childbirth?
At the time of delivery, the baby travels through the birth canal or vagina. Although this area is stretchy and can expand to accommodate the baby’s size, occasionally a baby may require more space. When this happens, the perineum (the area between the anus and vulva) may enlarge beyond its capability and endure some tears in the process. Some tears are superficial and may heal naturally. However, some tears can be severe, involving the muscle tissues and may lead to substantial bleeding and significant pain. Therefore, they require stitches.
In some cases, women may have to undergo episiotomy. Episiotomy is a surgical incision made at the perineum to widen the opening in order to help the baby pass through easily and to avert tearing of tissues at the time of delivery. In such cases, stitches are required as well.
When Does a Tear Need Stitches?
Tearing of tissues commonly occurs during delivery especially in the case of first-time mothers. Tears may greatly differ in severity. Tears can be largely divided into four classes:
- First-degree tear: Some of the tears can be so minor that they may heal on their own without any treatment. They are superficial as they involve only the perineum’s skin and the outer layer of the vaginal opening. They often require no stitches and heal rapidly.
- Second-degree tear: Some tears run deeper extending up to the muscles below the skin. These require being stitched through the layers of skin. They generally heal in a few weeks’ time.
- Third-degree tear: Some tears are more severe and can stretch deep through the perineal tissues and muscles till the anal sphincter (muscle around the anus). They definitely need stitches and can cause significant pain for a few months. These tears can put you at a risk of anal incontinence (unintentional passing of stools).
- Fourth-degree tear: This is a serious kind of tear that goes further deep through the muscles that are around the anus and the tissue beneath it till the rectum. It may require a small operation to stitch up the tear.
In some cases, a tear may ensue on top of the vagina, close to the urethra. These tears are usually very small and may require few or no stitches. They generally don’t include the muscles, hence heal very fast. They may result in discomfort while peeing.
How The Stitching Is Done
If it is a minor tear, you may be stitched in the room itself where you have delivered. The obstetrician after administering a local anaesthetic, to numb the concerned area, will close up the tear with a “running stitch”. Mostly, dissolvable stitches are used as they are not required to be removed on healing.
Cases involving episiotomy or second to third-degree tear, where the tear runs deeper through the skin to the muscles, the patient is usually transferred to an operating theatre. The obstetrician may give a local anaesthetic through epidural (spinal) or in some cases general anaesthetic, depending on the degree of damage and thereafter, stitch the perineum. A thin tube (catheter) may be put into the bladder, to empty out the urine. This will enable the perineum to heal quickly. Usually, episiotomy stitches are absorbable or dissolvable sutures.
How Long Does it Take to Heal?
Normal delivery stitches healing time is generally less, especially if good care is taken. The healing procedure usually takes 2-3 weeks after delivery, in case of normal episiotomy, which involves a small incision. But this process may vary from person to person. Also, the larger the tear, more may be the healing time. The pain may reduce after a week but the discomfort may continue for a month or so.
A more serious tear which involves deeper stitches may take longer to heal. It may take 6 to 8 weeks to heal entirely. The pain may be experienced for about a month. The stitches often begin to itch around the time they start healing. It may be a good idea to schedule a checkup with the doctor at around 6 weeks to monitor the progress of the stitches.
How Can You Soothe the Tender Area?
Stitches can be fairly painful after a normal delivery. Certain things that can be done to soothe them are as follows:
- Sitting in a tub of cold water may not only help soothe the sore stitches but also ease the swelling. Keep in mind to gently pat the area dry later on with a soft, clean towel. Alternatively, a cold compress or a gel pack can also be used.
- While sitting if you experience pain, you may try looking for ring-shaped inflatable pillows or valley cushion that are specially designed to offer comfort while sitting.
- To relieve pressure from your perineum while passing stool, gently press a clean pad over the stitches.
- If you feel discomfort while peeing, you may find putting warm water on the area useful in easing the burning sensation.
- Bear in mind to keep the perineum and vaginal area clean and dry to prevent normal delivery stitches infection.
- You may opt for safe painkillers to deal with the pain but it is advisable to first consult a doctor in this respect.
Tips to Recover Faster
Here is a list of tips that can help to recover faster:
- Putting some lavender oil on the stitches may provide relief from pain as lavender oil has remarkable antiseptic properties.
- Remember to wash the vaginal area with water every time after urinating and clean your bottom carefully from front to back.
- Exposing the stitches to fresh air every day for 10-15 min may help them dry faster.
- Bear in mind to clean the stitches with warm water and non-perfumed, gentle soaps.
- Soaking in a tub of warm water for 15-20 min, few times in a day can prove helpful in easing the pain.
- Include a lot of fibre in your diet, have balanced meals and drink plenty of water to prevent constipation.
- It may be sensible to use commode style toilets instead of Indian style so as to avoid exerting unnecessary pressure on the stitches.
- Taking regular short walks and doing certain pelvic floor exercises can aid in boosting the blood circulation which may fasten the recovery process.
- It is essential to wash hands properly after using the toilet and before changing the maternity pads to prevent the spreading of infection.
- Refrain from lifting hefty weights and doing strenuous exercises to avoid needless distress to the stitches.
- It is important to maintain proper personal hygiene by keeping the vaginal area dry and clean to reduce the risk of possible infections.Frequently change maternity pads and take care that they don’t irritate the sore stitches by rubbing against them.
Can You Avoid Having Stitches?
Most doctors may like to go for an episiotomy for normal delivery, particularly in the case of first-time moms. Still, if you wish to avoid having stitches, it is best to discuss your options with the doctor at length like having labour in water.
There may be certain things that can be tried to reduce the possibility of a severe tear during delivery like gently massaging the perineum daily during pregnancy, applying a warm compress on the perineum at the time of labour. You can also ask your prenatal instructor to teach you proper squatting and pelvic floor exercises or yoga to strengthen the pelvic muscles and enhance skin elasticity.
Will It Cause Problems in the Future?
It is important to understand to care properly for the after delivery stitches so that they heal safely and fully. Some women may experience pain during intercourse. In such a scenario, it is best to wait for a while and let the stitches heal properly. In some cases, women may be troubled with continued perineal pain, difficulty in regulating the stool or bladder. Whatever may be the problem, it can be prevented by taking good care of your health, eating healthy and exercising regularly. If the problem still persists, seek appropriate medical help.
When to Consult Your Gynaecologist
Despite good care, sometimes certain complications may arise with stitches. It is advisable to consult your gynaecologist in case you experience the following:
- Constant and severe normal delivery stitches pain.
- Foul smell from the vaginal area.
- High fever and chills.
- Intense burning sensation while peeing.
- Lack of control over bowel movements.
- Uncontrollable bleeding especially clots.
- Excessive redness or swelling of the stitches.
- Unusual discharge from the stitches.
It is not difficult to understand why many women may like to avoid having stitches at the time of delivery. But some tearing of tissue during childbirth is inevitable and is considered a usual part of the entire process of birth. The important thing is to take sufficient rest and stay healthy to help recover faster and to heal completely.