Forest Trees

Vaginal soreness, vaginal grazes,
vaginal tears and episiotomy recovery

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Vaginal soreness, bruising and pain

You will likely experience soreness, discomfort or pain in your vaginal region which will last for a few days or weeks after birth. Vaginal soreness and bruising can affect the vagina, labia and perineum (the area between your vagina and anus). 
 

This soreness and tenderness is due to the swelling and stretching of your soft tissues and the passage of baby down the birth canal. It is not a serious symptom and will ease off fairly soon after birth. However, it can be uncomfortable or painful, so you may find it useful to try the tips below to ease your discomfort and help your recovery.

Vaginal grazes/abrasions, tears and episiotomy

You may have experienced more serious trauma to your soft tissue in the form of a graze, tear or an episiotomy. These are also known as perineal tears and are classified by degrees of severity, based on which areas are affected.

 

  • First degree - small tears or grazes on/around the skin of the vagina, labia and clitoris.

  • Second degree - tears to the skin and muscles of the vagina and perineum. It will require surgery and stitches.

  • Third degree - tear to the vagina and perineum that extends to the edge of the muscles of the anal sphincter. It will require surgery and stitches.

  • Fourth degree - deep tear to the vagina and perineum which extends into the muscles of the anal sphincter. It will require surgery and stitches.

Episiotomy - a small diagonal cut purposefully made by the midwife or doctor to the back of the vagina and into the perineum to allow baby to pass more easily. This will also require stitches and is completed under a local anaesthetic painkiller.

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A third or fourth degree tear and an episiotomy will all require surgery and stiches soon after birth. This surgery may be delivered by your midwife at your birthing bed/location or, if more severe, it may require that you be moved to an operating theatre.

 

Ask your midwife or medical practitioner whether you can still have skin-to-skin time with your baby straight after birth, so that you are not separated too soon and can try to establish breast feeding.

 

Your wound will be stitched using dissolvable stiches and you will need to take care to ensure that it heals well. You can ask your midwife or GP to check that is healing well whilst you are under their care or if any concerns arise.

How to help yourself heal and recover

Your body has the ability to heal itself, but healing is a fragile process and wounds will not heal well if they are not nurtured, or are interrupted by poor nutrition, infection or too much moisture etc. 

 

The healing of your soft tissues and wounds will need favourable internal and external conditions in order to heal successfully.  You can support and speed up the healing process by doing the following:

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  • Keep your wounds clean and protected from infection and wash daily (non-perfumed, mild products).

  • Wash your hands before and after changing your maternity pad.

  • Keep your wound protected from re-injury by wearing a thick maternity pad.

  • Rest the soft tissues and your body as much as possible.

  • Avoid touching the area and don't apply direct contact to the vaginal region.

  • Use a doughnut pillow/cushion to sit on to relieve the pressure.

  • Avoid sexual activity until you are fully healed, comfortable and have had your 6-8 week postnatal check.

  • Avoid using tampons until it has healed, lochia has stopped and your first period has returned.

  • Do pelvic floor exercises (kegels) to increase blood flow to the area, rehabilitate the pelvic floor muscles and help to reduce incontinence.

  • Pat the area dry instead of rubbing.

  • Pour warm water over your vagina as you urinate and wipe from front to back after going to the toilet.

  • Have a sitz bath (a shallow basin, 3 inches deep, for up to 20 mins) that allows you to soak only your bottom).

  • Apply a warm compress (damp warm flannel) against your perineum.

  • Apply an ice packs (wrapped in a towel) to temporarily ease the swelling and relieve pain.

  • Wear loose, comfortable and breathable (cotton) underwear and clothing.

  • Eat a nutrient dense diet and stay hydrated to facilitate healing.

  • Keep your stools soft by eating high-fibre, water-filled foods and stool softeners.

  • Reduce your expose to mental and emotional stress.

  • Seek painkiller advice from your midwife or GP.

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Red flags-when to seek help

It is vital that you take care of yourself and focus some of your attention on your recovery so that you can spot any warning signs and seek medical attention when required.  Familiarise yourself with the list below and make sure that you tell your midwife, health visitor or GP immediately if you experience any of these symptoms, as they could indicate a problem that requires further investigation or immediate treatment.

  • Re-opening of stiches or the wound.

  • Foul smelling wound or discharge.

  • Pus or discharge from the wound.

  • A wound that does not appear to be healing or symptoms worsen.

  • A wound that becomes more painful rather than less painful.

  • Fever over (38C), chills, sweating.

  • Wind or faecal incontinence.

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How you can support your partner

You can support your partner by ensuring that they are as comfortable as possible and abstain from sexual activity until the feel ready and comfortable. Below are some ways that you can be supportive:

 

  • Ask them what you can do to help and best support them.

  • Pass them the doughnut cushion so that they can sit comfortably.

  • Prepare them a sitz bath.

  • Prepare high fibre, water-filed fruits for them.

  • Prepare drinks to help them stay hydrated.

  • Remind them to take their stool softeners.

  • Abstain from sexual activity until they are healed and have had their 6-8 week postnatal check.