You have been given this leaflet because you have experienced trauma to your perineum (the area between your vagina and back passage) during the delivery of your baby. It explains the different types of trauma, how to look after yourself and follow up care. If you have any questions please ask the hospital midwife while you are here or your community midwife once you are home.
What is perineal trauma? It is not uncommon to experience perineal trauma after giving birth to your baby. 9 out of 10 women will experience some form of trauma with the majority sustaining a 1st or 2nd degree tear, or less common, an episiotomy (cut).
What do the different types of perineal trauma mean? 1st degree tear is a small, superficial skin tear inside your vagina or anywhere on your labia 2nd degree tear is deeper, involving the skin and underlying muscles of the vaginal wall and perineum. An episiotomy is a cut made deliberately to make more space to delivery your baby. This can be performed during a normal delivery or an assisted delivery.
2
How will I know what perineal damage I have? Just after your baby’s birth the midwife or doctor will examine you and then inform you whether you require any stitches and what type of tear you have. If you are not sure what type of damage you have please ask a midwife.
How is the tear or cut repaired? In most instances, the midwife or doctor who helped you to give birth will repair your perineum. This will take place where you gave birth. You will be helped into a position where it is easy for the midwife or doctor to see what they are doing. A local anaesthetic by injection will be used to numb the area that needs stitching. The stitches will be dissolvable and take about a month to completely dissolve. This means that it is unlikely that your stitches will have to be removed. You will not be able to see any of your stitches. This method is much less painful and there is less chance of infection.
3
Care of your stitches The perineal area generally heals very quickly – usually within 2 weeks. There are some simple steps to help healing and reduce the chance of developing complications. These are: Keeping the area around the tear clean It is important to reduce the risk of infection by ensuring you wash your hands before and after changing pads or cleaning your perineum (the skin between the vagina and the back passage) as this is the most effective way to reduce cross infection. Some common minor infections such as sore throats in children can be transferred and cause life-threatening infections to mothers after they have given birth Have a bath or shower at least once a day Change your sanitary pads regularly, at least every 4 hours Drink at least 1.5 - 2 litres of fluid every day Eat a healthy balanced diet to ensure that your bowels are opened regularly and prevent you from being constipated.
4
Pain relieving medications Oral pain relieving medications such as paracetamol and ibuprofen may help in the first few days. Please read the drug information leaflet provided by the drug manufacturer Both of these drugs are safe when breastfeeding Homeopathic / alternative therapies It is important to seek advice from a Registered Homeopath before using such remedies. Pelvic floor exercises Do pelvic floor muscle exercises as soon as you can after birth. These exercises help to strengthen the muscle of the pelvic floor, which comes under great strain in pregnancy and childbirth. They will also increase the circulation of blood to the area and aid the healing process. If you need advice about the exercises please ask a midwife.
Follow up Your Midwife will usually visit you until 10-14 days after delivery and discuss perineal care and ensure healing of your perineum is taking place.
5
Please contact your Midwife or GP (General Practitioner) if: You have increased pain, redness or increased swelling around the perineal area or an offensive smelling discharge. They will need to review your wound and start appropriate treatment Your pain is severe or lasts more than 10 days You feel unwell, hot or clammy, then make contact immediately so you can be assessed as soon as possible
How soon can you resume sexual intercourse? This is dependent on how you feel. You may prefer to wait until the vaginal bleeding has stopped as this allows time for healing to take place and prevents infection. You may feel tenderness the first few times you have sexual intercourse – using water soluble lubricant may help. If you experience difficulties, such as painful intercourse, please contact your GP for advice. Please Remember: if you have unprotected sex you may become pregnant straight away.
6
Further information If you have any questions or concerns please contact the hospital Midwife, community Midwife or GP Space for Notes or Questions
7
If you need this information in another format or language, please telephone 01536 492510. Further information about the Trust is available on the following websites: KGH - www.kgh.nhs.uk | NHS Choices - www.nhs.uk Ref: PI.780 March 2016
