As if childbirth wasn’t enough to deal with, there’s all the afterbirth stuff nobody ever talks about that you have to contend with, too — like tearing. Yes, either by an episiotomy or by chance, you might get a gash during delivery that could require stitches. And since you (and your vagina) have gone through a lot during labor, it might not be easy to know if everything is alright down there postpartum. If you’re concerned, these are the six signs that your vaginal stitches aren’t healing properly after childbirth.
Hey, it happens to the best of us, but if you tore during delivery or if you had an episiotomy, you’re going to need stitches. And while having a tear in your perineum might make you wince just thinking about it, it’s imperative to make sure that it heals properly. Thing is, you just might not know what to look for. “It can be really hard to determine because immediately postpartum, there’s a lot happening in the vaginal area,” Dr. Kiarra King, MD, FACOG, an OB/GYN tells Romper in a phone interview. “The mom will have some bleeding occurring because of normal postpartum changes, so it’s not an easy place to look and see what’s happening.”
The good news, though, is that most women will never have to confront an infected tear — with basic care, they tend to heal up very well, noted Healthline. However, when the tear is deep, as with a third or fourth degree laceration, the healing process can be much more complicated. What To Expect reported that deep tears occur naturally in less than 2 % of cases.
Ultimately, what is going to help in the healing process is how well you take care of the vaginal stitches, a study published in PubMed found. In fact, it was found that “the best possible personal hygiene is a key to healing,” researchers found. Make sure you keep the area as clean as possible after going to the bathroom (that’s where that spray bottle they give you in the hospital comes in handy), cleaning yourself well so that you can decrease the chance of infection.
Now, if you happen to have a more severe perineal tear, how long will it take to heal? "Repaired vaginal lacerations or episiotomies take a long time to heal, like any injury. The stitches usually take three to seven days to dissolve," board-certified OB-GYN Dr. Mary Jacobson, Chief Medical Director at Alpha Medical, tells Romper. "Be patient and give the repair six weeks to heal — and expect several weeks of soreness and tenderness during the healing process. If your vaginal repair isn’t healing properly, you may have an infection."
But no matter what kind of vaginal tear you have, here are some signs that your stitches aren't healing properly.
The Stitches Smell Badly
While you can expect to bleed for up to six weeks post birth, the smell of blood will be different from stinky stitches. If your stitches smell, that's a sign of infection you absolutely shouldn't ignore, advised Healthline, and Jacobsen says that's one of the first signs you should reach out to your doctor. Certified Nurse Midwife Michelle Barcus tells Romper the same, saying, “Foul-smelling or green infected looking discharge that is new is a sign you might have an infection.”
Excessive Redness
Excessive redness or swelling in the vaginal or perineal area is another red flag of infection. "Significant swelling in the area," is a sign you should call your doctor, according to Jacobsen, and Barcus says "swelling that is getting worse and redness to the tissue area surrounding the stitches," are signs you should see your provider right away. Basically, anything icky or weird from this wound might merit a call. Even if you just think there might be something icky or weird about it — call. While you're probably busy with the baby, it's equally important to take care of yourself.
Your Stitches Hurt — Like, A Lot
You shouldn't have to put up with excessive pain after birth — ever. While some aching and soreness is normal, let your doctor know if the pain is serious. But how can you tell what’s normal healing and what’s not? “If they deemed your vaginal exam to be normal at the hospital before discharge, then I would use that as a baseline,” advises Dr. King. “But if you get home and have extreme pain that is not well-relieved by the pain medication you’ve been provided, that would be the time to give the doctor’s office a call.” If you describe your symptoms, they might tell you it’s part of the healing process, but they also might have you come in for a quick exam to ensure everything is okay.
Your Stitches Have Gaps and Breaks
You should always keep an eye on your stitches to make sure that there aren’t any breaks or gaps. You’ll need to use a mirror, obviously, so you can get a good look down there to ensure that they’re healing properly. Dr. Vonne Jones, MD, FACOG, an OB/GYN, tells Romper how to do it. “If you're looking for signs and symptoms of the sutures actually breaking down, you might feel increased pain in the lower portion of the vagina, or you may see a suture come out when you're urinating or having a bowel movement,” she says. “Sometimes patients say that they hear a pop where they feel like a split happened, and then they'll notice a difference in their discharge because of it.”
You Have A Fever
One sure sign your wound may not have completely healed despite treatment is if you develop a fever, according to Jacobsen. This can be another sign of an infection, so you'll want to reach out to your doctor ASAP. "You want to monitor for any signs of infection such as new onset fevers (>100.4)," says Barcus. So if you’re feeling feverish, call your OB/GYN, since it might not be obvious if you have an infection.
You Have Fecal Incontinence
One of the fun parts of the postpartum phase is all the gassiness you might experience. But if you have to scurry to the bathroom to go number two, or if you're leaking when passing gas, your laceration might be worse than anticipated, and stitches might not be enough. As Baby Center explained, a fourth degree tear can impact your rectum. "Be sure to do your Kegel exercises daily in order to prevent urinary and fecal incontinence as you age," Jacobsen says. "Kegel exercises strengthen your pelvic floor muscles. Your pelvic floor muscles support the uterus, bladder, small intestine, and rectum."
If at any time something seems wrong with your stitches, you’ll want to contact your OB/GYN right away. They’ll be able to identify immediately if there’s a potential infection or something has gone astray with your stitches and provide proper medical treatment. Soon, you (and your vagina) will start to feel like yourselves again.
Study cited:
Faruel-Fosse, H., “Post-delivery care after episiotomy” 2006.
Experts:
Dr. Kiarra King, MD, FACOG, an OB/GYN
Dr. Vonne Jones, MD, FACOG, an OB/GYN
Dr. Mary Jacobson, Chief Medical Director at Alpha Medical
Dr. Sara Twogood, OB-GYN
Michelle Barcus, CNM at Einstein Medical Center Montgomery
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