I remember my doctor saying — in an ominous horror movie tone just weeks before I gave birth — everybody tears. While that's not 100% true, knowing the signs your vaginal stitches aren't healing properly after childbirth was important for me. I mean, it's rare for a first-time mom to get through childbirth without a stitch or two, and some suffer deep lacerations in the form of third or fourth degree tears. If you've given birth recently, and are concerned about how things are going down there, you're definitely not alone.
First, let's talk prevention, because, as you already know, an ounce of that good stuff is worth a pound of cure. Healthline recommended sitting on an ice pack for 10 minutes at a time in the first 24 hours to help decrease inflammation and promote healing. In addition, ask your doctor about taking a stool softener. An over-the-counter product like Colace means you don't have to "bear down" as much on those stitches when you go to the bathroom. A sitz bath can also help you care for a painful bottom area, according to The Bump. Until your stitches have disappeared or been removed, and until your wounds are fully healed, avoid sexual intercourse.
How long will it take a tear 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. "My best advice is to 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."
The good news 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 percent of cases.
But you should pay special attention to any tear that is the result of episiotomy. "One main downside to an episiotomy is extension of the incision into a 3rd or 4th degree laceration," explains Dr. Sara Twogood, OB-GYN. "These types of lacerations are rare but are more likely to cause worse pelvic floor symptoms (pain, incontinence) than a second degree tear." She tells Romper that episiotomies may also bleed more, and are more likely to heal poorly than a regular, or spontaneous, tear.
But no matter what kind of vaginal tear you have, here are some signs that your stitches aren't healing properly.
1. The Stitches Smell Foul
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.
2. 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 merits 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.
But there is something that might seem strange, and isn't. "As the stitches dissolve, you may notice a mucous discharge, which is normal," Jacobsen says. So just keep an eye on what's happening down there.
3. It Hurts — Like, A Lot
You shouldn't have to put up with excessive pain after birth — ever. While some aching and burning during urination is normal, let your doctor know if the pain is serious. Jacobsen says, "much more pain at the site of the stitches than when you came home" can signal an infection. Barcus agrees, and says, "Increased pain in the area of the stitches that wasn’t there before," is not a great sign.
4. Gaps and Breaks
Stork Mama strongly recommended carefully monitoring your stitches for gaps, breaks, and lumps daily. Use a mirror and try not to touch the area too much. (If you do touch, use a clean cloth, not your finger.) Occasionally, stitches need to be re-sutured at your doctor's office.
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)," Barcus tells Romper.
6. Fecal Incontinence
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."
Barcus says if any of these signs are present, you'll want to "seek care with your provider right away. If you are healing well, the pain, swelling, and overall feeling of the vagina will improve daily."
Dr. Sara Twogood, OB-GYN
Michelle Barcus, CNM at Einstein Medical Center Montgomery