How to Care for Stitches After Vaginal Delivery

When the baby passes through the vaginal route, it needs more space to come out and due to this the perineum stretches and tears. The tear in the perineal area is checked and taken care of immediately after delivery. The doctor will numb the perineal area by giving you local anesthesia and then stitch the torn area. If you feel even a little pain, tell the doctor.

The torn area is stitched with stitches to prevent infection. To facilitate delivery and to avoid irregular tearing of the perineum, stitches are required for the deliberately made incision. This surgical incision is called an episiotomy.

Episiotomies are done only when it is needed and can be prescribed by the doctor. However, they are not very common. In this process, obstetric forceps or ventouse (Ventouse - this is a vacuum device which is put on the baby's head and taken out) is used. In this situation, the doctor will cut your perineum and the baby will be born easily.

(Read more - After delivery care for the mother)

Generally there are four degrees of tearing of the perineal area, which are as follows:

First degree
This type of tear is small. It usually heals even without stitches. These usually cause little or no discomfort as they are in the outer layer and tissue of the skin or vagina.

Second degree
These types of tears are deep and reach the muscles. These incisions are stitched layer by layer and closed. You will have some discomfort from these and you will recover in a few weeks. In this process, the stitches dissolve.

Third degree
This is a deep and severe tear in the skin and muscles of the perineal region. Sometimes, it reaches the muscles around the rectal area. About 4% of women have this degree of tear and it causes you a lot of pain for several months.

Fourth degree
This degree tear is the most severe type of tear and extends beyond the anal muscles. In this case, stitches are always needed. Third and fourth degree tears can put you at risk of anal irregularities.

(Read more - Relief During Childbirth)

The doctor numbs the perineal area by giving local anesthesia and then very carefully stitches the incision. These stitches later become less painful and less uncomfortable. Apart from this, they dissolve on their own and do not need to be cut later. In case of third or fourth degree stitches, the stitches are done in the operation theater. Spinal or epidural anesthesia is necessary if the pain is severe.

A thin tube (catheter) is inserted into the bladder to collect urine. This prevents infection around the perineum and also keeps the area dry. Antibiotics help the stitches heal quickly. Painkillers are given to relieve pain. Plenty of rest is recommended to speed up the natural healing process. You are also advised not to sit for long periods for the next 24 hours.

(Read more - Relief During Childbirth)

Perineal stitches can be painful, so you need to take care of them and do everything possible to facilitate the healing process. Here are some tips to help with the healing of stitches:

• Keep the stitched area clean to avoid infection.
• Take a bath daily and take utmost care of hygiene.
• Wash your hands with a good antiseptic soap before and after using the toilet.
• Change sanitary pads regularly.
• Do pelvic exercises daily. This improves blood circulation and speeds up the healing process.
• Take bed rest and expose the stitched area to air without panties for at least 10 minutes i.e. allow air to flow into the stitches.
• You should wear loose cotton shorts and avoid tight-fitting trousers. Loose shorts facilitate air exchange.
• At the most, consume about 3 to 4 liters of fluids. Fiber-rich foods like brown rice, whole-wheat bread, vegetables and fruits. This prevents constipation and keeps you healthy.
• Keep taking antibiotics to protect yourself from infection for five days. Laxatives are given to prevent constipation and straining of the tender tyres.
• Always keep yourself dry from back to front. This prevents bacteria from entering the vagina.
• Sitz bath or hip bath is done 24 hours after delivery.
• Kegel exercise is very important for its treatment. It speeds up the healing process.

(Read more -How To Take Care During Pregnancy)

After perineal stitches, you are advised to take antibiotics for 5 days to avoid infection. The doctor may also prescribe you laxatives so that it becomes easier for you to defecate. In the case of severe stitches, you will be advised not to put any pressure on the stitches, and you can ask your doctor about painkillers. Although paracetamol is a safe option, we still suggest you use painkillers prescribed by your doctor. The following signs indicate the possibility of infection in perineal stitches:

• High fever.
• Experience of pain or redness at the site of the incision.
• Strong odor or discharge from the stitches.
• Bleeding from the incision.
• If you have a bowel movement while defecating.

Painful stitches can be quite bothersome. Here are some simple tips that you should follow to soothe the sore area:

• Apply a frozen or cold gel pad to the perineum. Wrap this pack in a clean flannel garment. But don't keep it on for too long. Apply the pack twice a day.
• Whenever you urinate, pour lukewarm water over the perineal area.
• Do not use tampons until the stitches have dried.
• Consult a doctor if pain or swelling persists.
• Use a cushion to sit on.
• You can also take ibuprofen if the pain is severe. Consult a doctor before taking any painkillers.
• Keep the perineum clean and dry.

The following are some emergencies after stitching that require immediate treatment, so contact the doctor immediately if you experience any of these:

• If the stitches become smelly and painful, it may be a sign of infection.
• Difficulty controlling stools.
• Pain while passing wind.
• Painful urination.
• Smelly discharge from the stitches.
• Experiencing stinging and severe pain.
• Frequent urination.
• Pain in the lower abdomen and around the perineal area.
• Chills and fever.
• Clots coming out of the vagina.

After delivery, especially if an episiotomy (cut between the vagina and the anus) has been done during a normal delivery, stitches may be needed. These stitches help in healing the wound quickly and prevent infection. Caring for stitches is very important to avoid infection or any other complications. It is important to keep the stitches clean and dry, follow the advice given by the doctor, and take proper care. Usually, stitches should heal within a few weeks, but it is important to consult a doctor in case of pain, swelling, or any other problems. It is also important to rest during this time and eat a nutritious diet to keep the body healthy.