How long is this going to last?

November 11, 2011 2:18 PM

I gave birth about 3 weeks ago to my first baby (yay!). Unfortunately, though, it was a very difficult delivery and I ended up with a third degree tear to my perineum. I am still in pain and was just wondering if others who had severe tears could let me know their recovery experiences and timelines.

Immediately after the birth, when I had my stitches still in, I was sitting up in bed to breastfeed. It was a bit painful, but I could do it. About a week ago, my stitches started dissolving.... and now the pain is much worse. I can't really sit at all, so I'm spending my days alternately lying down and standing up. When I have to sit, it is really uncomfortable and I end up bleeding a bit from the wound. I also bleed from the wound every time I have a bowel movement, and I am unable to hold any gas in... it just comes right out. I am really hoping this doesn't last forever.

I went to my midwife a few days ago and she examined the perineum - she said that the healing looks normal for this stage. I am taking 2-3 sitz baths a day, and doing kegel exercises.

How long should I expect to be in pain? If you had a third or fourth degree tear, how long did it take before you could sit comfortably? Did you have any longlasting damage? Is there anything else I could be doing to help speed recovery? I'm just sick of feeling bad and worrying that I will be this way forever.

posted by anonymous to health & fitness (22 answers total)

Is your midwife a nurse-practitioner (who would presumably have the training to judge whether or not the tear is healing nicely or not)?

If not, you might consider consulting a doctor to get a second opinion.
posted by KokuRyu at 2:21 PM on November 11, 2011 [2 favorites]

4th degree here. It took several weeks to feel normal. I have no longterm damage or pain, except for a slight painless bump of skin where it healed. The only advice I have is to rest, rest, and then rest some more. Do even less than you're doing now. Yeah I realize that advice is as useful as "sleep when the baby sleeps," but try to stay in bed if you can.

Good luck and congratulations on the baby!
posted by ellenaim at 2:26 PM on November 11, 2011 [1 favorite]

I had a third degree tear with my first, and it was a little uncomfortable for a few days. Never really had any particular pain while sitting, as long as I kept up with ibuprofen dosage early on. Tenderness while sitting down, but not uncomfortable once I was settled. I would say the pain was like you describe while I was still in the hospital (but again, well addressed by ibuprofen), and much easier by the time I was discharged. I think I kept up with ibuprofen for about 10 days, but only occasionally after about day 5. I had terrible itching when the stitches started to dissolve and some worry around pooping for a couple of weeks, but that was it. So I'd say this is not that normal. My midwife also said that there was lots they could do if the healing didn't go right, so be sure to speak up and they'd refer me along to specialists. Longterm, the scar area felt pretty weird (not painful) for about 6-8 months.
posted by pekala at 2:40 PM on November 11, 2011 [1 favorite]

Could you check with your medical professionals and find out if putting stuff like aloe vera juice or vitamin E on the tear is ok?

And congrats on the little one!
posted by luckynerd at 2:57 PM on November 11, 2011

Do you have a doughnut ring for sitting and a I hope (assume, cannot imagine you don't) a peri bottle?
posted by DarlingBri at 3:22 PM on November 11, 2011

3rd degree here! after a few weeks it stopped hurting and all together felt "normal" very shortly after my 6 week check up.

I promise you it will get better & you'll probably forget all about it soon. Congrats!!
posted by katypickle at 4:53 PM on November 11, 2011

I'd expect things to feel weird for several months if not more. With my 2nd, I tore very little but things felt just weird for a while, like 8-10 weeks, to the point that I made several appts. Each appt I'd say "is everything ok? is this normal?" It was ok but it was good to get it checked out. 3 weeks is nothin'.
posted by kirst27 at 4:58 PM on November 11, 2011

My wife had two first degrees going sideways and a third degree going against those. She was in a terrible way for months.

Relax, as ellenaim said, and have a glass of wine.
posted by zombieApoc at 5:03 PM on November 11, 2011

Second degree tear veteran here. What really saved me was Dermoplast and the Preparation H pads with witch hazel. It's got to get better soon.

Congrats on the little one!
posted by Leezie at 5:38 PM on November 11, 2011

I had a tear (didn't want to know how bad!) and an episiotomy and then tore a stitch and had a reaction to the sutures (yuck). I felt better at about the 7 week point. Stick with the sitz baths and I also took tylenol, which really helped (I was also given the tylenol with codine, but I didn't like the constipation so I didn't take much). It gets better! I'm at week 12 now and everything is fine.
posted by cestmoi15 at 5:50 PM on November 11, 2011

A very good friend of mine answered this question via email.

She says:

I don't mind answering, but it's going to be graphic!

Had 4th degree tear, 50 stitches, 2 months of period-like to heavy bleeding, and an additional surgery to remove large amounts of scar tissue 7 months after the birth. Good doctor/surgeon thank god, so she stitched everything up as well as she could. Probably felt totally "normal" a little after a year from birth. Mostly dealing with pain/sensitivity around scar tissue areas is what took the longest.

Took metamucil everyday with lunch to help ease things out (totally safe while breastfeeding). Peri bottle and Sitz baths 3-4 times a day were quite soothing. Also used a numbing antiseptic spray (Lidocaine?) after Sitz bath that was safe for genital area. I cried with the huge amount of relief the spray gave me. Good stuff. Basically just soldiered through. As far as sex was concerned, attempts were made, but nothing that wasn't excruciatingly painful before 5 or 6 months out from birth.

It does get better eventually, it can just take a long time. If it doesn't start feeling better after a few months, best to talk to the doctor. The additional surgery I had to remove the scar tissue helped immensely, and the doctor said a lot of women just suffer through it instead of getting help. Glad I did.

Hope this helps!

posted by bilabial at 6:02 PM on November 11, 2011 [2 favorites]

I don't know what degree my tear was, but something that helped me considerably was at the peri-squirt bottle (is this standard issue? I had a home birth) filled with warm water (or sits herbs). I squirted my sore bits generously during every bathroom session. I don't know if it helped the healing go faster or if it just prevented continuous damage to the area, but it's worth a try.
posted by LyndsayMW at 6:22 PM on November 11, 2011

3rd degree here (forceps delivery where the little one was pretty much dragged out). It took a couple of months for me to get to normal. By the time I went back to work (10 weeks later) I think I was at the point of not feeling anything amiss down there. I had a patch of skin that healed weird over the stitches, my doctor used a silver nitrate stick to chemically burn the weird skin off. She said it would sting "for a minute or two." Holy shit, I kid you not, I was crying in pain every time I peed for at least week. That stuff was uncool, but the discomfort from the weird healing was also uncool. I had the gas problem, too. It was horribly embarrassing, there was literally nothing I could do to prevent it. I am pretty sure that was done by the time I went back to work. I can tell you that it's been 15 months and everything has been completely back to normal for a long time now. At the time when I was post-partum I thought it would never feel right again. That on top of breastfeeding difficulties... the first month and a half of maternity leave was really rough.

I did the sitz baths, but they sucked and hurt, though I carried on because I figured it was good to flush things out down there. What helped was putting a combination of witch hazel, aloe, and lavender oil on pads- sometimes putting the pads in the fridge, but even room temp the witch hazel helped a lot (I think the lavender was to mitigate the smell of the witch hazel, that stuff was kind of rank). And ibuprofen. Also I drank a gross amount of prune juice because pooping scared the ever living hell out of me for weeks.
posted by banjo_and_the_pork at 6:23 PM on November 11, 2011

One of my BFFs had whatever the worst kind of tear is. (I will not use her graphic description here.) She was in pain and had lingering effects for a while, but her youngest is now 17 and she's 100% fine. She actually taught to maternity classes about tearing and so forth for years and years because her case was pretty extreme. But within 6 months she was basically back to normal.

(The farting, um, I think that's just a thing that happens to some post-partum women. I'm 16 weeks out from a C-section and, um, yeah. My doctor says it's totally normal. I look forward to a future when I can MAKE IT WAIT until I'm at least in a hallway or something.)

I set an alarm on my phone for a time of day when I'm not usually significantly busy to remind me to do kegels, after I got a bit away from the birth and started forgetting them. That has helped some.
posted by Eyebrows McGee at 8:15 PM on November 11, 2011

As an aside, regarding post-partum sex (not that you're probably worrying about this just yet), one thing that surprised me was that sex was quite painful even after I'd healed up. The culprit was breastfeeding - apparently the hormones do something to your lady parts that makes it all very uncomfortable - for me that was an understatement... it took a good couple of months after weaning until it all felt normal again. Congratulations and I hope you have a fast recovery.
posted by 8k at 1:48 AM on November 12, 2011

The nurses in the hospital taught me this trick and it helped SO MUCH: Place a layer of Tucks (or other witch-hazel laden gauzy type pads) on top of a maxi pad. Atop that, spray Dermoplast (healing spray designed for minor cuts and burns). Sigh with relief.
posted by sonika at 4:14 AM on November 12, 2011 [2 favorites]

Episiotomy for the first, tearing for the second. I agree that at three weeks it's normal for things to still feel very tender. Definitely follow it up with your doctor if it feels like it's getting worse, not better, but your very much still in the first part of the healing process.

I'm sure you'll be fine and your vag will feel like your own again. It's completely normal for it to take some time. As far as the pooing goes, leaning forward and resting your arms on your knees when you sit makes a hell of a difference. Taking Metamucil et al. for the promotion of nice, soft turds (go away mental image) is a great idea also. And as for the farting, you just had a baby. Fart with abandon. Claim it proudly or blame it on the baby, whatever works for you.
posted by h00py at 6:01 AM on November 12, 2011

(Fart control will also return, eventually).
posted by h00py at 6:03 AM on November 12, 2011

I had a third degree tear with my first child, 14 years ago. Witch hazel, peri-bottle and ibuprophen are all great. I continued to wet a maxi pad and freeze it to wear off and on for the first 2 weeks. The worst was that I had very little control of my bowel movements, when I had to go, I had to go right away. I didn't leave my house after a meal for the first month.

I have a very high tolerance for pain and this injury nearly did me in. It did get better and everything healed up perfectly but I spent weeks shamelessly sitting on a hemorrhoid pillow. The pillow came into play after about day 4 and made a huge difference. It embarrassed my dad but the pain was excruciating when I didn't use it.
posted by myselfasme at 6:09 AM on November 12, 2011

I just thought of something- Hemorrhoids can make you bleed with every bowel movements and can also cause pain. I had an external one from the first delivery and that made healing from the tear more painful. You might want to ask your doctor to check from an internal one.
posted by myselfasme at 6:14 AM on November 12, 2011

I tore interestingly with my baby, and it took way longer than I felt it should to heal. One of my midwives did a house visit around the third week because I called them panicking about how things were healing. They were reassuring. I basically sent the first two weeks in bed. When I tried to get out of bed, I bled more and hurt more. The third week I spent on the couch. And, oh yes, the gas problems. (Keep in mind, also, that you're getting effects not JUST from the tearing -- I had a really long second stage, and it turns out that it takes weeks for your perineum to recover from 10+ hours of pushing.)

Another thing to remember is hormones. I normally have a high pain/injury tolerance, and recovery from childbirth left me in anguish. I was freaking out, convinced I would never ride a bicycle again, much less have sex. (One despairing evening, I wailed, "But I wanted to have more than one baby!") It gets better.

I'm nine months out, and things are basically back to "normal". There's the unfortunate penetrative pain that seems to be caused by breastfeeding hormones, but my body feels good again. Things are different! But they feel fine. They definitely felt fine by twelve weeks, and improved from there.
posted by linettasky at 10:21 AM on November 12, 2011

Just another data point about penetrative sex: I'm breastfeeding and it took about five months for everything to feel "normal," by which I mean the NEW normal as contents definitely shifted during flight. (And by "flight," I mean five hours of pushing and a minor tear.) I don't really have much of a libido, but when I do - penetration is totally as awesome as it used to be.
posted by sonika at 10:29 AM on November 12, 2011