Approximately 90% of first-time mothers who deliver vaginally experience some form of perineal tear, graze or episiotomy. These tears can occur spontaneously during natural delivery or as a medical intervention to widen the vaginal opening and facilitate delivery. (1)

Depending on the extent of these tears, stitches may be required in the perineal area. It is important to follow your doctor's instructions for caring for the stitches to ensure proper healing and recovery.

Stitch Care After Vaginal Birth

Here are some important steps to ensure optimal care, minimize discomfort, and facilitate a smooth recovery: (2)(3)

Keep the area clean and dry:

• Wash your hands with soap and water before and after cleaning the area.
• Use lukewarm or warm water to gently cleanse the stitches.
• Do not use any type of soap or shampoo on the stitches while showering.
• Change sanitary pads regularly (at least every 4 hours).
• Gently pat the area with a clean, soft towel or paper towel.

Sitz bath: 

• Sit in a warm sitz bath for 15-20 minutes, 3 times a day to soothe the area.
• Gently dry the area with a soft, clean towel after each sitz bath.

Rest:

• Get plenty of rest in the first few days following delivery.
• Avoid strenuous activities or lifting heavy objects to prevent reopening the stitches.
• Allow the stitches to air out by lying down without underwear on a towel for about 10 minutes twice a day.
• Wear breathable cotton underwear and avoid tight clothing.
• Maintain mild to moderate physical activity to aid in overall recovery.

Pain relief:

• Use the painkillers prescribed by your doctor as needed.
• Apply a cold compress or ice wrapped in a towel to the area for 20 to 30 minutes several times a day.
• Sit on a donut-shaped cushion to relieve pressure on the stitches.
• Take regular warm baths to help you relax.

Care during urination:

• Gently pour warm water over your vulva during urination to minimize stinging.
• Lean slightly forward while sitting on the toilet to direct urine away from the incision.
• Rinse the area thoroughly with water afterward and gently pat it dry.

Care during bowel movements:

• Place a clean pad or tissue near the stitches and press gently during bowel movements to reduce strain.
• After finishing, pour warm water over the vulva and perineum, then gently pat the area dry with a soft, clean towel.
• Wipe gently from front to back.
• Drink plenty of fluids and eat fiber-rich foods to avoid constipation.
• Your doctor may recommend a stool softener or laxative if bowel movements are very painful.
• Do not worry; bowel movements will not cause the stitches or incision to open.

How Long Does it Take for Stitches to Dissolve After Vaginal Delivery?

Postpartum stitches typically dissolve on their own within 1-2 weeks. You may notice small pieces of the stitches on your pads or when using the toilet. Generally, the tears from a natural birth fully heals in about a month. (4)

When to See a Doctor

Contact your doctor if you notice any signs of infection or other unusual symptoms, such as: (5)

• Heavy bleeding.
• Severe pain, redness, or swelling at the suture site.
• Foul-smelling discharge.
• Opening of the sutures.
• Fever and chills
• Difficulty or pain when urinating, or frequent urge to urinate.
• Constipation for a week after delivery

If you experience any of these symptoms, contact our gynecology and obstetrics department immediately for exceptional care.

References

1. NHS - Episiotomy and perineal tears
2. NCT - Care and recovery after tearing or episiotomy
3. HSE - Recovering after an episiotomy
4. MyHealth.Alberta.ca - Perineal Tear: What to Expect at Home‍
5. Saint Luke's - Incision Care After Vaginal Birth