Postpartum Recovery: Healing from a Perineal Tear
Women often find themselves concerned about tearing during pushing, if it does happen, how do you optimally recover?
During pregnancy many women focus on preparing for delivery, often specifically, reducing tears during delivery. Will I tear? How bad will it be? How can I prevent this? We do not want one more thing to worry about while we recovery from delivery and learn to navigate life with a newborn. We all want to prevent the possibility of tearing during delivery, but sometimes it happens anyways. When it does happen, there is a lot of information and help out there to ease and optimize your postpartum recovery.
Preventing tears during delivery
If you're reading this post and you are still expecting, let me take a few moments to share with you some effective ways to help prevent tearing. First, I'm sure you have heard of perineal massage in pregnancy, some research says that it can cause micro tears, which causes lots of little scarring. We all know that scar tissue does not stretch very well, so some providers say to skip the pregnancy perineal massage. We will let you look over the evidence yourself and decide if perineal massage in pregnancy is something for you to do or not. Then we have the very effective left side-lying pushing to reduce pressure and allow the tissue to stretch nicely. Additionally, allowing your body to push when it is ready, or breathing down your baby until it is much lower in the birth canal reduces swelling which in turn reduces the stressed tissue from tearing.
What to do if you do tear and how to optimize perineal recovery
First, give your self grace and rest. With a first degree tear you may not always need sutures. If the tissue acclimates well it tends to heal very well and adding in stitches can just further agitate the tissue. Tears come in degrees, first, second (most common), third and fourth (which is pretty rare). Keeping your legs together. Keeping your legs together helps the tissue stick together and not pop out your stitches. Reducing the amount of times you go up the stairs. Again this is not only opening your legs and possibly stretching the tissue that is stitched together but also puts weight on your perineum while it is stretched. Come down in the morning and go up at night if possible. Have your Postpartum Doula grab things as needed and you just rest. Buy Earth Mama Angel Baby Mama "New Mama Bottom Spray". Actually, buy two bottles, you will love it and need it. Even if you do not end up tearing the spray helps your tissue heal and heal well. When the itching happens, dab coconut oil. As the tear really begins to heal, maybe 2 weeks postpartum, you may notice itching, try not to itch, but instead dab coconut oil or use some bottom spray. Not too much, you do not want the tissue to be saturated, just use enough to relieve the itching. Additionally an Herbal Sitz bath with healing, restorative herbs is also a great addition to your routine. Wellness Mama has a DIY recipe or you can find a pre-made bag at Mountain Rose Herbs.
If you do end up tearing, just know that you can recover. Pay attention to your body as you recover, if it is telling you to rest, rest. Allowing your body to heal properly for a few weeks will make the rest of your life easier, and easier if you decide to have more babies.