perineum tears

5 things you need to know about perineum tears

Perineum tears are a reality that many, many folks face during vaginal birth.

Your perineum is the space between your vagina and your anus. When you get a perineum tear it will occur when you’re pushing your baby out of your vagina. Sometimes the skin doesn’t adjust enough or your baby has a larger head, and you tear.

The thought of a perineum tear might make you cringe, and believe me, I’m right there with you.

There are four degrees of perineum tears:

First degree:

This is when the perineum tear only (I say “only” lightly, believe me) affects the perineal skin. This type of tear may or may not require stitches.

Second degree:

This is when the tear goes through the perineal skin and into the muscle (and possibly into the vagina). This tear usually requires stitches.

Third degree:

This tear goes from the vaginal opening to the muscle that surrounds the anus. It’s likely that you’ll require anaesthetic and surgery for this tear.

Fourth degree:

(Give me a second….this one’s a doozy…) This tear is fucked up, I don’t even understand how it is a thing, and I’m sorry to anyone who’s experienced one. This perineal tear runs from your vagina, through the anal sphincter, and into the mucous membrane that lines the rectum. This tear almost entirely will require surgical repair. Don’t worry, these tears are not common.

The healing time entirely depends on the degree of perineum tear you experience, your body, and your healing process.

Can you avoid perineum tears?

So, yes and no. There are ways that you can stretch your perineum while you’re pregnant like in this post about vagina yoga, however, there’s really no telling how big your baby’s head is going to be and how your body is going to respond to birth.

So, what does it feel like to have a perineum tear?

I tore with my first and second babies. They were second degree tears that required a few stitches. By my third and fourth baby, my vagina apparently learned her lesson and I didn’t have any tears.

I can’t say you’re going to “know” when you tore. When your baby is passing through the vaginal opening it hurts. It’s not called the ring of fire for nothing! The pain almost numbs the area so that if you do have a perineum tear you don’t really feel it happen, though.

I can’t speak to a third or fourth-degree tear, but I imagine it would make things more painful.

What happens after you have a perineum tear?

Perineum tears happen to a lot of folks who have a vaginal birth. These are 5 things you need to know about perineum tears!

Again, depending on the degree of tear your recovery will look different.

For first and second degree tears you might need stitches. If this is the case you’ll receive a local anesthetic and then be sutured.

For a third and fourth-degree tear, depending on the severity, you may require a surgery to repair the tear. In this case, your healthcare professional will have a conversation with you regarding how to go about healing your perineum tear.

How can you recover from a perineum tear?

(There are some affiliate links in these suggestions. I am not being paid to endorse these products-I do it because I believe in them-however, I may receive compensation at no cost to you if you purchase through the links)

-Use a peri-bottle instead of wiping. Pat yourself dry instead of wiping. Air dry if you can. Apply some perineum balm after you’re dried off.

-Eat lots of fibrous foods so that you don’t get constipated and feel the need to bear down

Use a perineum spray from Earth Mama Angel.

-Change your pad every 4 hours or so. Make sure that the adrea is clean.

-Leave your stitches alone. If you’re up to it, take a peek with a mirror because it’s kinda crazy cool that you have badass stitches that nobody (?) will get to see, but for the most part avoid touching them.

-Give a sitz bath a go.

(Add this herbal mix to make it even more effective!)

when you're overdue

Things not to do when you’re overdue

When you’re given a due date it’s hard to deal when that date comes and goes and suddenly you’re overdue.

The average typical gestation is 40 weeks. Of course, this is an average but it’s funny how hopeful we become when we’re immensely uncomfortable and supposed to get relief on a certain day.

Let me tell you, once you’ve reached your due date you reach a whole new level of “get this kid out of me”.

If you’re like me you’ve had 1, or 2, 3, or 4 babies AFTER your due date, so reading on, please do understand that I’m VERY empathetic to your situation!

Things NOT to do while waiting for your overdue baby:

15 ways your body changes after birth (that nobody else will tell you)

 

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Forget that your “due date” is actually an “estimated due date”.

I’m sorry to tell you, but there’s no real sure-fire way to know when your baby will come unless you have a scheduled cesarean.

Jump on the trampoline.

Seriously, you can barely waddle my way up the stairs. You’ll more than likely break something if you start jumping on the trampoline and it won’t likely be your water.

Have sex, go for long walks, and eat spicy food.

Ok, so none of those things are actually a bad idea unless you figure doing all 3 at the same time would be most effective. (*Avoid sex if your water has broken, you have vaginal bleeding, or you’ve been told by your healthcare professional to avoid it.)

Tell anyone when your due date was.

Of course, you're getting super excited to meet your baby, but there are a few things you shouldn't do when you're overdue!

The sympathetic looks and “hang in there” comments won’t make the baby come any faster, and it’ll just get increasingly more annoying. You’ll also likely get daily phone calls from your family asking if the baby is born yet. My suggestion: Let them know that you have not had the baby yet and that you will certainly let them know…in your voicemail message.

Beg, threaten, or bribe baby.

Trust me, your baby doesn’t care if you’re willing to give it $100.

Eat baby out of house and home.

The 45 lbs of raspberries on the counter seems like an appropriate way to overcrowd baby. Nope. You’ll get a massive bellyache in your massive belly bump…and still no baby.

 

Unfortunately, the only thing you can really do is…WAIT. Ahhh, I know. That’s not what you wanted to hear, but your baby will come when they’re ready.

In the meantime, take advantage of the things you can do when you’re overdue:

-Rest

-Finish getting ready for baby

-Make some freezer meals

-Use your belly to get you to the front of the coffee line up

-Enjoy those last few times of telling people you’re not pregnant when they ask when you’re due

 

Did anything work for you to encourage your baby to come?

 

 

strong-vagina-1

Does childbirth give you a loose vagina?

You may or may not have heard of the “husband stitch” as a preventative measure for a loose vagina after childbirth.

If you have I can hear your “ugh…yes”. If you haven’t, allow me to explain:

Are you about to give birth?

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    After you have gone through hours of painful labor and pushed a massive child out of your vagina you may get to experience being stitched up in case you tore or had an episiotomy. A “husband stitch” takes this one step further and one extra stitch is given during the repair of the vaginal tissues after a tear or episiotomy to make sure that there’s no loose vagina as a result of bringing a child into the world.

    Now, this seems like it might be one of those wives tales like in this post, but according to many accounts of women who have experienced it, it is not. While it is not common practice it has been known to happen (mostly with consent from the woman-but not always).

    Your delicate vaginal opening has experienced frequent (?) penetration from something around 3” in diameter (or more. Listen, I’m not here to judge whatsoever. I thought I was fucked, BTW), and if you have a traumatic birth can all contribute to how stretched your vagina gets.

    For example, a person having their first uncomplicated vaginal birth at age 20 may experience a vaginal snap back easier than someone having their third baby with second-degree tears at age 30.

    That said, regardless of your situation, your elastic vagina will spring back to it’s pre-Good Goddess there’s a baby coming out of me-shape, it just may take a bit more time for some folks than others.

    What do I do about a vaginal laxity?

    Hey, just a heads up that I’m an affiliate for the links below. That means that if you purchase one of these courses I may receive a commission. It’ll be “tight” for the both of us! Fuck, I’m hilarious.

    The ol’ husband stitch isn’t the ideal way to fix a loose vagina in any way. in fact, it might be worthwhile to have that chat with your partner, midwife, or doctor to make it entirely clear that you and your vagina would appreciate sutures only up to where your natural vaginal opening begins.

    A bit of a shift in your pelvic floor is normal after you’ve had a baby but there are some preventative measures you can take while you’re pregnant to make sure that you don’t experience anything above and beyond a little bit of extra vaginal elasticity (think prolapse, extended urinary incontinence, painful intercourse).

    Pelvic floor physiotherapy is a corrective measure as well as a preventative measure. That means that you can take a proactive approach to your pelvic floor health now as you sit there in your pregnant glory so that you don’t have to do a more intensive therapy if you do end up needing extra support after you have vaginal childbirth.

    Your pelvic floor is a muscle that needs working out to keep strong. You spend time toning those quads….your pal Your Vagina needs the same TLC!

    Aside from knowing that you’ve got a buff muff (you can keep this info to yourself or share your accomplishment. Either way, you’ve got my mad respect) having a strong pelvic floor will help you with your labor as well as help you avoid issues that may arise in your pelvic floor as a result of childbirth.

    Have a conversation with your healthcare provider about what they recommend, but I highly suggest checking out The Vagina Coach. Not only is she straight up about pelvic floor health, but she offers some amazing courses that will help you get those pelvic floor muscles in tip-top shape for your labor.

    If you’ve already given birth and have been under the impression that you have a “loose vagina” you can find some courses through her that will help you regain elasticity to allow you to get back to things like running without peeing or increased sexual pleasure.

    From my personal experience (in case you didn’t click on the highlighted “I thought I was fucked” text-I talked about my four kids that I had vaginally) strengthening your pelvic floor is an absolute must-do during your pregnancy and as maintenance after your baby is born.

    how to make a sitz bath social media

    This is how to make a sitz bath

    You’ve probably heard of a sitz bath being part of your postpartum care routine, but you’re also probably wondering what the heck it actually is.

    Allow me to explain:

    Your perineum is the space between your vaginal opening and your anus. It’s a sensitive spot (as to be expected) and is also the most ravaged spot of your body as you push your baby out of your vagina. While your perineum is meant to stretch to accommodate for large things going out (i.e. baby) or large things going in (i.e. *insert raised eyebrows and knowing smile*) it is apt to tear.

    You can prepare your perineum by following the guidelines in this post but even then you may suffer some pretty severe tears, or, at the very least, discomfort from the significant stretching that was required to push that baby of yours out.

    Your perineum is a rockstar and after the birth of your baby it needs an extra little bit of tender loving care. Enter: Sitz bath!

    Who needs a sitz bath?

    Well, I mean, ANYONE really can use a sitz bath. It’s meant to clean the perineum and provide relief from any discomfort, itching, or irritation. Some folks who have just given birth may opt to use one, as well as someone who’s enjoying the wonder that is haemorrhoids.

    What do you need for a sitz bath?

    There are very few things that you need for a sitz bath, however, it’s nice to have it prepared before baby comes so that you have these things ready and available for the exact time that you need them:

    -clean bathtub (get your partner or support person to give it a good scrub before you go in. Use a little bit of bleach to make sure that you’ve killed all bacteria that may be in there. The last thing you’re going to need right now is an infection!)

    or

    -sitz bath toilet kit (that you can find in this post)

    -warm water

    -additives to the bath (optional) that you can purchase here or make on your own using ingredients such as witch hazel, calendula, lavender essential oil, epsom salts, salt, chamomile.

    How to have a sitz bath

    You've heard of a sitz bath. Do you know why they're so awesome and how easy they are to make in the comfort of your own home?

    First things first: this is your self-care time! You’re taking care of the lovely perineum of yours but you can also turn this into a pleasant experience for yourself.

    1. Hand the baby off to someone else if you are able to do so. If not, bring baby into the bathroom and either lay them on a blanket beside the bathtub or in a bassinet-wherever you can reach them if you need to and however you feel most comfortable.
    2. Fill the bathtub about 1/3 of the way full with warm water. Avoid making this too hot or you’ll probably feel some discomfort.
    3. Add the various herbs if you’ve chosen to do so.
    4. Sit in the bathtub for about 20 minutes. Add some more warm water if you feel like it’s getting too cold for you.
    5. Once you get out make sure to pat dry (don’t rub….ouch!!) or wear your birthday suit for a while and dry off au naturel.
    6. Do this 3-4 times a day unless you’re finding it irritating to your perineum

    While a sitz bath can promote healing in your postpartum body if you aren’t enjoying them try and find another way to let your body heal. The key to healing your perineum is to make sure that it’s clean, dry, and not irritated. There are many ways that you can do this so a sitz bath is only one option.

    Did you use sitz baths after your birth? What were your favourite things to add? Please share recipes in the comments below to share with fellow new parents!

    7 reasons you should wait to have sex after childbirth social media

    7 Reasons you should wait for sex after childbirth

    Chances are you’re not going to feel like having sex after childbirth for quite some time.

    Some partners understand this (particularly the ones that witnessed a vaginal birth, while others may be having a more difficult time coming to terms with waiting 6 weeks. Not that you need to justify yourself but there are some physical and mental reasons that you can fill them in on.

    Most healthcare providers are going to tell you to wait 4-6 weeks until having sex after childbirth and these are the reasons why:

    7 Reasons to wait for sex after childbirth

    Vaginal discomfort

    Okay, so you just pushed a BABY out of your vagina. That means that you pushed a watermelon-sized head out of a loonie sized vagina. #proudcanadianwoman

    Even if you didn’t have any sort of tearing or episiotomy you probably are feeling a little stretched thin-yes, literally and figuratively, but we’ll get to the figurative part later. Your labia has been stretched and is likely feeling a little tender. It will take a few weeks for everything to be a little less sensitive and may need some being left alone during that time.

    Stitches

    If you’ve had a cesarean birth you will have stitches or staples in your lower abdomen. If you’ve had a tear or episiotomy you likely have stitches in your perineum.

    Neither of these healing wounds should be irritated until, well, they’re healed. Depending on the severity of the wound this will take at least two weeks.

    Infection

    You've been told to wait for 6 weeks to have sex after childbirth, but do you know the reasons why?

    Before approximately the 6 week mark your cervix is still dilated from childbirth. This leaves your body open to infection that may occur from a penis or other objects being inserted into the vagina. You’ll know that your cervix is still open if you’re bleeding or by going to see your healthcare professional for a check-up.

    Be careful with taking chances on infection; truthfully, the last thing you’re going to want to deal with on top of your healing body and a newborn baby is a vaginal infection.

    General body discomfort

    It may seem logical that your pain and discomfort is going to be centralized to your vagina or surgical site. Unfortunately, it doesn’t end there.

    Your entire body is going to be experiencing a world of change: back pain from 9 million months of pregnancy, excess fluid, shoulder pain from nursing, aching breasts, sore feet, tired body, etc. etc. etc..

    You’ve just had a workout of a lifetime and you may not be up to a romp session.

    This is 100% okay.

    Discharge

    You, my friend, have a lot of stuff coming out of your vagina. Blood, mucus, uterine tissue will come out strong for about 10 days after birth and then taper off somewhat until around the 6-week mark when it stops.

    This is your body’s way of expelling all of the now unnecessary fluid, so if you have sex after childbirth when this discharge is being, well, discharged it will be quite akin to having sex while on your period.

    *One thing to note is that the smell of the discharge after childbirth is different than when you have your period-it’s stronger and just plain different. This can be hard to get around when trying to get in the mood.

    **One thing to note on the one thing to note is that if your discharge is foul-smelling you should see your healthcare provider to rule out an existing infection.

    Decreased sex drive

    Ohhhhh hormones, you bastards.

    Your body is a tornado of hormones from the remaining pregnancy ones to the breastfeeding ones to the childbirth ones. What a mix.

    Oh! Ya! I almost forgot to mention the inevitable sleep loss that you can factor in, too, and right there you’ve got yourself the makings of a (probably) decreased sex drive. It can also lead to decreased lubrication regardless of if you’re aroused or not. You may not have had to use lubricant before but having a water-based one on hand now is a good idea.

    Changes in breasts

    Breastfeeding causes higher levels of prolactin and lower levels of estrogen in the nursing parent. This can, like above, lead to a lower sexual desire.

    Some folks find it very uncomfortable to have their breasts touched in a sexual manner when they’re breastfeeding while others find it to be a turn on. This is a conversation that you and your partner should have before resuming sexual activity.

    For breastfeeding parents, there may be leaking or even spraying (!) during an orgasm. Some partners find this arousing while others find it unnerving. If it’s something that’s not for either of you it can be a quick fix with a nursing bra and nursing pads.

    Time

    You just fed the baby. They’re snug as a bug in a rug and you’re certain they’re going to be asleep for at least a couple hours while you and your partner(s) give this sex after childbirth thing a go.

    You do a half happy, half sexy dance, take off your clothes, start getting frisky, and….WAHHHHHHHHHHH!

    Baby wakes up and the mood is killed.

    It takes a few weeks to really get into the groove of having a newborn. That’s not to say that at the 6 week mark your baby is suddenly entirely predictable, but you’ll likely have a bit more awareness to their patterns.

    Emotional readiness

    There are so many variables when it comes to a person’s sexuality, especially after they’ve given birth.

    It’s by far one of the most vulnerable, exposed times in a person’s life and sometimes that can take some coming back from. Particularly in cases where there’s been trauma during birth, it can be very challenging for people to want to open themselves back up to that vulnerability.

    Getting back into having sex after childbirth is something that should be given great care and consideration. Your first priority is making sure that your body is healthy and able to engage in sex after childbirth-you can be sure of this by allowing yourself time to heal and by checking in with your healthcare professional for medical clearance before jumping your partner(s).

    When you do decide that you’re ready try and keep these few things in mind.

    1. Begin with an open dialogue about how and when to resume sex after childbirth. Make sure that each partner is on the same page and comfortable with plans going forward.
    2. Lower expectations. If things don’t go smoothly the first time give it some time before trying again.
    3. Start small. Try masturbation first to become re-acquainted with your body. Then, finger penetration with your partner a couple of times. Then, give penetrative sex a go when you’re ready.

    Have fun! Oh, and now that you’re a parent you can go ahead and give “7 best sex positions for parents” a read. You’re going to need to know these.

    fundal massage

    What to expect: Fundal Massage

    Midwife: “Okay, I’m going to give you a fundal massage now.”

    Oooh a massage right after delivering your baby? Sounds absolutely divine, right?!

    It’s not.

    The word “massage” being paired with the word “fundal” is about as misleading as “FREE!!! (with $6000 purchase).

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      (Hey, before you read on please remember that I am not a medical healthcare professional. I obtain this knowledge from my personal experiences and research that I do. If you have questions or concerns please refer to your healthcare provider. This is meant to be as an awareness and starting point of education.)

      What is a fundal massage?

      Other than a super uncomfortable assault on your poor tummy immediately after birthing your placenta, a fundal massage is a firm pressing and “massaging” of your fundus (the top of your uterus) to get rid of blood, clots, and everything else that needs to not be in your body after birth. If this is not done your chance of postpartum hemorrhage (excessive bleeding after birth) is increased.

      Your midwife or doctor will warn you that they’re going to give you a fundal massage. They’ll basically knead your belly right above the pubic bone while having fingers in your vagina to compress the uterine arteries. Unfortunately, this is not necessarily a gentle process. In order to make sure that all the excess bits and bobs are expelled from your body your healthcare professional will need to use a bit of force.

      While postpartum hemorrhaging is not very common the preventative measure that is fundal massage helps to reduce the risk of it happening. Basically, if your uterus doesn’t contract on its own you may end up hemorrhaging, especially if you’ve delivered a large baby, had multiple babies, had an infection, had a history of hemorrhaging, amongst other variables. The fundal massage technique is used to simulate the contracting uterus to help your body.

      It’s not pleasant, but it is important.

      What do you do during a fundal massage?

      Getting a fundal massage doesn’t really require much of you. You’ll likely be able to hold your baby but you may find it more comfortable to pass baby to someone else so you can put your mind in a happy place. You’ll not only be feeling the pressure of the fundal massage on your body, but you’ll also be feeling the gushing from your vagina.

      Don’t worry about that last part. I promise you that your midwife or doctor has made the necessary arrangements with pads and clean up items so that your bed won’t be saturated. In fact, when all is said and done there won’t be any evidence that it even happened.

      Fundal massage sounds lovely, but it's not as glamarous as you think. This is what you need to know about this necessary discomfort!

      Do I have to have a fundal massage?

      Postpartum hemorrhage is when a person loses 500ml to 1 liter of blood in the first 24 hours after birth. That’s a lot of blood. In fact, that’s a life-threatening amount of blood to lose. That level of blood loss can cause a dramatic drop in your heart rate leading to shock and potentially death.

      1-5% of people who give birth will experience a postpartum hemorrhage. It usually happens shortly after delivery but it can happen up to two weeks postpartum.

      Some common symptoms of postpartum hemorrhaging are:

      -Uncontrolled bleeding

      -Decreased blood pressure

      -Increased heart rate

      However, some of the other symptoms of postpartum hemorrhage can resemble other health concerns. If something doesn’t feel right make sure to make an appointment with your healthcare professional immediately or seek immediate medical assistance. Tune into your body. You’re going to be experiencing a lot of new and different sensations, especially if this is your first birth, but listen to your body and be in tune when something doesn’t feel right. Always err on the side of caution if you are concerned-you’re taking care of yourself and most healthcare professionals are happy to investigate further into your concerns.

      None of the above sounds terribly appealing, does it? Fundal massage is the first defense towards having to deal with this both immediately after birth or in the near future. This is not something you want to have to deal with once you’ve brought baby home.

      While it may not be the most glamorous massage you’ve ever gotten it’s nothing in comparison to what you just experienced while delivering your baby. Besides, you’ll be able to use your fundal massage as leverage for quite some time when you explain to your partner that you need a real, pleasant massage to negate the trauma that you endured and to make sure that your perception of what a “massage” is isn’t forever skewed!