As if childbirth wasn’t enough to deal with, there’s all the afterbirth stuff nobody talks about that you have to contend with, too — like tearing. Either by an episiotomy or by chance, you could get a gash during delivery that requires 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, there are signs of infection in after-birth stitches to watch out for that mean they aren’t healing properly.
It happens to the best of us, but if you tore during delivery or 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, M.D., FACOG, OB-GYN, tells Romper “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 thing is, though, that most people will never have to confront an infected tear — with basic care, they tend to heal up very well. However, when the tear is deep, as with a third- or fourth-degree laceration, the healing process can be much more complicated. A 2015 study published in the Obstetrics and Gynecology journal found that 3.3% of people giving birth had a third-degree laceration and 1.1% had a fourth-degree laceration. And those rates increase during a second pregnancy if a tear occurred in the first, according to a 2014 study in BJOG.
How long do after-birth tears take to heal?
Ultimately, the healing process will depend on how well you take care of the vaginal stitches. 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 you can decrease the chance of infection.
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."
No matter what kind of vaginal tear you have, here are some signs that your stitches aren't healing properly.
Signs of infection in after-birth stitches
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.
Friedman, A. M., Ananth, C. V., Prendergast, E., D'Alton, M. E., & Wright, J. D. (2015). Evaluation of third-degree and fourth-degree laceration rates as quality indicators. Obstetrics and gynecology, 125(4), 927–937. https://doi.org/10.1097/AOG.0000000000000720
Edozien, LC, Gurol-Urganci, I, Cromwell, DA, Adams, EJ, Richmond, DH, Mahmood, TA, van der Meulen, JH. (2014). Impact of third- and fourth-degree perineal tears at first birth on subsequent pregnancy outcomes: a cohort study. BJOG2014; 121: 1695– 1704. https://doi.org/10.1111/1471-0528.12886
Dr. Kiarra King, MD, FACOG, OB-GYN
Dr. Vonne Jones, MD, FACOG, OB-GYN
Michelle Barcus, certified nurse midwife
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