Doctors or midwives often perform normal postnatal sutures to repair wounds to the vagina and perineum (the area between the vagina and anus) due to childbirth. During recovery, mothers who have just given birth need to take good care of these sutures to prevent infection.
When a normal delivery process takes place, the mother will push hard to open the birth canal so that the baby can be born. When the mother pushes and pushes the baby out of the womb, her vagina and perineum will be under very strong pressure.
This has a high risk of causing lacerations to the vagina and perineum which can cause postpartum bleeding. Therefore, to repair the torn part, the doctor or midwife will perform stitches.
In addition to natural tears due to the pushing process, normal postnatal sutures are also performed if the mother undergoes an episiotomy procedure, which is an incision made in the mother's perineum and vagina to facilitate the delivery of the baby.
This procedure is usually performed on mothers who have certain conditions, such as suffering from serious illnesses, such as heart disease, prolonged labor, and breech babies.
Vaginal Tear Rate After Childbirth
Tear in the vagina and perineum after childbirth can be grouped into several levels according to size or depth, namely:
Level 1
The tear occurs in the layers of skin and tissue around the vagina, but has not yet reached the muscles. The tear is small and heals without suturing.
Level 2
The tear that occurs is deeper and involves not only the skin and tissues around the vagina, but also the muscles. Grade 2 tears often need to be stitched layer by layer and can take weeks for the stitches to heal.
Level 3
Grade 3 tears include tears in the skin, perineal muscles, and the muscles surrounding the anus. The tear was severe and had to be stitched in the operating room. In certain cases, mothers who experience severe perineal tears can experience complications in the form of fecal incontinence and pain during sexual intercourse.
Level 4
A grade 4 tear is deeper than the anal muscle, reaching even the intestines. The suturing process must also be done in the operating room.
Just like a grade 3 tear, a grade 4 tear can also cause complications even after stitching. These complications can include fecal incontinence and pain that can last for months.
Mothers who gave birth normally will mostly experience grades 1 and 2 perineal tears and only a small percentage of mothers will experience grades 3 and 4 perineal tears.
- Giving birth to their first child or breech baby
- Undergoing assisted delivery forceps
- Giving birth to a baby with a large size or a baby weighing more than 4 kilograms
- Pushing too long
- Have a history of grade 3 or 4 tears in previous deliveries
To reduce the risk of a severe tear in the perineum during childbirth, pregnant women are advised to exercise regularly and do Kegel exercises.
In addition, to increase the flexibility of the muscles of the birth canal and prevent severe perineal tears, pregnant women can also do perineal massage when their gestational age is around 34 weeks.
How to take care of normal postpartum stitches
Almost 90% of mothers who gave birth vaginally will get stitches after normal delivery. To support the post-natal wound recovery process and take good care of stitches, there are several things that mothers can do, namely:
- Sit slowly and use a donut-shaped pillow to support your body when you want to sit.
- Avoid lifting heavy weights or straining for a few days after the wound is stitched.
- Compress the stitches with ice cubes wrapped in a cloth, to reduce itching and pain in this area.
- Clean the stitches after urinating and defecating, then dry the wound area.
- Change sanitary napkins after delivery regularly and always wash your hands before and after putting them on.
- Do Kegel exercises to strengthen muscles and speed up the healing of post-natal sutures.
- Consume fiber-rich foods and drink lots of water to prevent constipation, so defecation becomes easier and does not interfere with perineal sutures.
To overcome severe pain due to stitches after normal delivery, mothers can also take painkillers, such as paracetamol, as recommended by the doctor. In addition, doctors will usually prescribe antibiotics to prevent infection after the vaginal and perineal wounds are sutured.
In general, normal postpartum suture is a safe and common procedure. You will also usually recover within a few days of getting normal postpartum stitches.
However, immediately consult a gynecologist if you experience symptoms of infection in the stitches, such as fever and sores that are very painful, swollen, or festering. To overcome the infection in the suture wound after normal delivery, the doctor will give medicines, both topical and oral medicine, as well as perform wound care.