Having a significant perineal tear during the birth of your baby can be a bit of a shock to say the least. For the first few days it can be quite painful and difficult to move around and especially to sit. You’ll need to allow yourself time to heal and recover so be gentle with yourself. If you tore a muscle in your leg, you’d probably be on crutches for a few weeks. And no one would blink an eyelid if you said you had to take 6 weeks off work and put your leg up. Yet you’re going home to take care of your new baby!

  1. Rest as much as you can.

    You may be saying to yourself ‘well of course I will, what else will I be able to do?’ But being at home is very different to being in hospital where your meals are provided, your bedclothes are changed for you. You don’t need to tidy, clean and cater for visitors. So have help sorted for home – let your partner do the cooking and cleaning or ask visitors to help out. Consider hiring a post partum doula or in-home nurse if you need more support.

  2. Sleep whenever you can, even if it’s just a 10 minute cat nap.

    Getting enough sleep is important for healing. And if you have a baby who doesn’t sleep much, expect your recovery to take a little longer.

  3. Take your pain medication.

    It’s really important that you’re not having a lot of pain. This can hinder your recovery. It cause also unhelpful movement patterns that can contribute to chronic pain after your tear has healed. If pain medication is not helping, or the stitches look red or infected, contact your maternity hospital, public health nurse or GP.

  4. Eat well.

    As busy new mums we can forget to look after and feed ourselves. Of course good nutritious meals will optimise our ability to heal well and quickly. Ask friends and relatives to bring food when visiting or ask your partner to cook. If this isn’t possible, your partner may be able to do a lot of the prep work so that it’s easier for you to put a meal together. Have some healthy snacks like fruit salad, nuts or boiled eggs ready in the fridge. Then you can grab something quickly in those rare few moments of peace!

  5. Keep your bowels regular.

    You’ll probably be on a laxative to keep your bowel movements soft and easier to pass. If not, you may want to speak to your public health nurse or GP about this. Go to the toilet regularly. The best time to go is about half an hour after breakfast, when our digestive system begins to get going again after slowing down during the night. TAKE YOUR TIME. That’s 5-7 minutes at least, sitting on the toilet!

    If you’re worried you won’t hear your baby cry, bring him with you in his moses basket or bouncer and leave him at the door where you can see him. Use the correct toileting position as shown. Our bowels are designed to empty in a squatting position. This will make it a little easier to pass a bowel movement.  Try to RELAX, don’t push or strain. If nothing comes, don’t worry. Try again later.

  6. Have a squirty bottle of water in the bathroom for when you need to pee.

    Running water over your stitches as you empty your bladder can reduce any uncomfortable stinging.

  7. Drink plenty of water.

    This will help keep your bowel movements soft and your urine clear or straw coloured reducing stinging.

  8. For the first few days it may be helpful to apply cold packs to the perineum.

    Remember not to put the cold packs directly against the area but wrap in a facecloth or paper towels. Placing a bag of sanitary towels in the freezer and taking them out as you need them can be handy for this. Again don’t apply directly to the skin.

  9. Most healthcare professionals advise not to apply any creams or ointments to the area or add anything to your bath water.

    If you do intend to use something on your stitches, check with your doctor or midwife first to make sure it’s suitable.

  10. Feed lying down.

    It can be uncomfortable to sit for long. Lying down feeding positions can be brilliant if you’re breastfeeding. If you’re formula feeding, you can ask someone else to feed the baby or you can prop him up on a pillow while you lie beside him to feed.

  11. Use cushions or towels to make sitting easier.

    Sitting on your feeding cushion or a towel rolled up in a ‘U’ shape can make it more comfortable for you to sit.

  12. Don’t worry too much about pelvic floor exercises for the first couple of days and weeks after the birth.

    If you were recovering from a hamstring tear, no one would be telling you you had to do lots of strengthening exercises the day after. There’ll be plenty of time to get going with pelvic floor exercises once the stitches are healed. For now, focus on abdominal breathing, relaxing the pelvic area as you inhale and keeping that relaxed feeling as you exhale. If you find this too difficult or frustrating, try a general whole-body relaxation to encourage awareness of any tension in your body generally, before narrowing your focus to the pelvic floor area.

  13. See your local women’s health physio.

    Most hospitals will refer your to their women’s health physiotherapist or you can choose to attend privately. Women’s health physios have extensive extra training in pelvic floor problems, as well as lots of other pregnancy and post pregnancy issues. They can help guide you, give you an idea of what you can expect, what’s normal and what’s not, at each stage of recovery after your tear.

  14. Don’t forget about your mental well being.

    If the birth didn’t go as you hoped and you’re struggling with this, speak to someone about it when you’re ready. A chat with a friend may be enough but some women choose to get a copy of their birth notes and debrief the birth with a midwife from the unit where they had their baby or a midwife that they know. Others may see a counsellor or mental health professional who is experienced in helping women after difficult birth experiences. You can also speak to your women’s health physio, public health nurse or GP who can refer you to the relevant health professional.

For more information about giving birth again having had a 3rd or 4th degree tear before, see my post here. To get in touch with any questions or worries, contact Louise at louise-carroll@hotmail.com or 0879229708

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