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What are maternal injuries from childbirth? — Maternal injuries from childbirth are tears in the skin and muscles around the vagina and "perineum" that happen to a woman during vaginal delivery. The perineum is the area between the opening of the vagina and the anus. Some of these injuries are minor and tear only the skin. Others are more serious and can tear skin and muscle. In some cases, the tear goes from the vagina to the anus. These injuries are also called "perineal injuries."
What causes maternal injuries from childbirth? — These injuries happen when the baby's head or shoulders tear the perineum during birth. The tears are more likely to happen if:
●The baby is very large
●The mother is giving birth for the first time
●The doctor or midwife helps pull the baby out with a tool called "forceps" or a special vacuum. This might be done if the baby gets partly stuck in the birth canal.
Doctors and midwives sometimes cut the perineum just before the baby comes out to make the opening of the vagina larger. This is called an "episiotomy." It is needed in less than 10 percent of births.
How are maternal injuries from childbirth treated? — Minor skin tears often need no treatment and heal on their own. If you have a tear that goes deeper, your doctor or midwife will use stitches to repair the tear. These stitches dissolve over time and do not need to be taken out.
What can I do to feel better while my injury heals? — Some people feel better if they:
●Take "sitz" baths – This is a shallow, warm bath that helps clean and heal the perineum. Take them at least twice a day for 5 to 10 minutes each. You can do it more frequently if you find it soothing. You do not need to add soap or any medicines to the water unless your doctor has recommended them. Pat the area dry with a soft towel. Do not rub.
●Use a "peri-bottle" after going to the bathroom – After you urinate or have a bowel movement, you can use a peri-bottle to clean yourself. This is a small squeeze bottle you can fill with warm water then use to rinse the area. Try to do this instead of wiping with toilet paper.
●Take medicines to relieve pain, such as acetaminophen (sample brand name: Tylenol) or ibuprofen (sample brand names: Advil, Motrin).
If you got stitches for a serious tear, your doctor or midwife might recommend foods or medicines to keep your bowel movements soft. This makes you less likely to strain to push out a bowel movement, which might reopen the tear.
You shouldn't have sex until the tears heal. Sex can be painful and might reopen the tear. You should also not use tampons, or put anything else in your vagina, until after you have healed.
You should have an appointment with your doctor or midwife after the delivery to check how you are healing. You might need more than one follow-up visit. They will tell you when it's OK to start having sex and using tampons again. When you start having sex again, it might be uncomfortable or even painful at first. You can use a water- or silicone-based vaginal lubricant to help with this. Examples of lubricants include K-Y Liquid, Replens, and Astroglide. Talk with your doctor or midwife if the discomfort doesn't go away with time.
You might have vaginal bleeding after your delivery for up to 6 weeks. If you have bleeding that is heavier than a period, call your doctor or midwife.
Can maternal injuries from childbirth be prevented? — There is nothing you can do before delivery to prevent a vaginal injury. During the birth, your doctor or midwife can help get the baby out in a way that lowers your chances of a bad tear. Some doctors and midwives use a warm cloth to put pressure on the perineum during delivery. But there is not good evidence that this works to prevent tearing.
Even if you had tearing during your first delivery, you might not have tearing during later deliveries.
Patient education: Labor and delivery (childbirth) (The Basics)
