Postpartum perineal care
The perineum is the anatomical area between the urethra. This channel carries urine from the bladder and the rectum. The vagina is positioned in the area of the perineum. This area experiences a lot of stress and changes during pregnancy and childbirth and needs special care continuously.
Some women experience cutting of the perineum/birth canal (episiotomy) when they give birth a baby. This action is carried out to speed up the labor process, although this intervention is not a necessity. This action can be done by prior planning (primary) or unplanned (secondary) when you see the perineum thinning and tear.
Episiotomy, a natural tear in the perineum and the act of suturing perineum after childbirth, are often quite a traumatic thing for mothers. Even some mothers say that the pain felt when the perineum stitched exceeds the pain. Also, when experiencing the contraction process and gives birth to the baby itself.
An episiotomy is a surgical incision made in the perineum to widen the hole to help the baby pass easily and prevent tissue tearing during labor. Lacerations are blisters to tears in the perineum. This can be corrected by suturing, but the tears with only 1 degree or just abrasions will usually heal itself without suturing (only perineal treatment). Whereas in episiotomy wounds, after the suturing process is completed, and when the episiotomy wound heals, it can form a scar. Mothers who have past episiotomy injuries must be very careful and prepare themselves and their bodies properly so that the wound does not re-open during the next labor.
Why Should It Be Sewn After Childbirth?
During labor, the baby is born through the birth canal or vagina. Although this area is flexible and can expand greatly to adjust the size of the baby, sometimes the baby may need more space. The perineum (the area between the rectum and vulva) can enlarge beyond its ability and tear during the delivery process. Some tears occur only lightly and may heal naturally even without sewing. However, some labor processes can occur with severe tears, involving muscle tissue and can cause substantial bleeding and significant pain. Therefore, they need stitches.
In some cases, the mother may have to experince an episiotomy. In such cases, sutures are also needed.
Perineal tears can be divided into four degrees:
- Degree 1: this is a very small tear that can heal itself without any treatment. Only superficial wounds because it only affects the perineal skin and the outer layer of the vaginal opening. This does not require stitches and will heal quickly.
- Degree 2: Some tears occur deeper into the muscles under the skin. This needs to be sewed through the skin layer. This generally recovers within a few weeks.
- Degree 3: Some tears are more severe and can stretch far through the perineal tissue and muscles to the anal sphincter (the muscles around the rectum). They need stitches and can cause significant pain for several months. This tear potentially has the risk for anal incontinence (unintentional bowel movements).
- Degree 4: This is a type of serious tear that goes deeper through the muscles around the anus and the underlying tissue to the anus. It may need an operation to recover.
What is the importance of treating stitches?
If the scar of the birth canal not treated well, it can be the cause of the germ and infection. As a result, the mother becomes hot, wet wounds and sutures. There is even a foul odor from the birth canal (vagina).
How to treat perineal wounds at home?
- After delivery, the perineum must remain clean. Spending lokhea can take up to four weeks, so sanitary pads must be replaced frequently.
- Do not use tampons after giving birth. Tampons can cause infection. After giving birth, ask the midwife or doctor whether there are still tampons attached. Do not get home without realizing there is a tampon in the vagina.
- Take a bath twice a day. Mothers can also take a bath with the sitz bath: sit soaking the perineum and buttocks with warm water added with several herbs to heal/heal wounds.
- Urination can be painful after giving birth. After you have finished urinating, pat your perineum gently with a tissue or soft and dry cotton cloth or a special towel.
- Try to meet the needs of fluids properly by drinking lots of water. Avoid constipation by eating fiber-rich foods such as fresh fruit and vegetables.
- Using an inflatable “donut” pillow while sitting or lying down can help reduce the pull on the episiotomy scar.
- Kegel exercises strengthen and flatten the pelvic muscles and reduce perineal pain.
- Avoid sexual intercourse until you no longer feel perineal pain. Most midwives recommend not having contact first until four weeks after giving birth.
- Perform puerperal exercises
When should you check for perineal problems postpartum?
If you have just given birth, check immediately if any of the following symptoms occur:
- Foul-smelling vaginal discharge from the vagina
- Burning pain by urinating
- Urination more often than usual
- Interference with resist urination
- Vaginal bleeding
- Severe pain in the perineum, pelvis or lower abdomen
- High fever
- Fart or out of feces through the vagina
- Open stitches
- Herpes that occurs in the vagina
Food so that the stitches dry out quickly
- Consume high protein foods
Proteins will be used by the body to build damaged tissue. When avoiding food sources of protein such as fish, the wound healing process can be hampered. As a result, the risk of getting an infection can be greater. Protein is also useful in the production of breast milk. Besides fish, the protein source that should be consumed is meat, chicken, eggs, or tofu.
- Eat high-fiber foods
This fiber is needed by postpartum mothers to facilitate defecation. Fruits and vegetables are a fairly high source of fiber.
- Eat high-energy foods
After giving birth, the mother must still be strong. Eating energizing food will help the body continue to provide energy. Food energy sources can be obtained from rice, pasta, potatoes, corn, or bread.
- Enough fluid intake
Drinking enough water will not affect non-dry wounds. If after giving birth to urination smoothly, and often clean the vagina properly, then the suture wound around it can immediately recover.
How long will the wound heal?
Usually, stitches will heal quickly between 1-2 weeks after giving birth. Especially, if you take care of it well. However, this process may be different for each mother. Besides, the bigger the tear, the longer the healing time. The pain can decrease after a week but, it can cause the discomfort can continue for about a month.
More serious tears that involve deeper seams may take longer to recover. It may take 6 to 8 weeks to heal completely. Pain may be experienced for about one month. Seams often begin to itch in the area around the suture usually felt when the wound begins to heal.