Healing Vaginal Tears from Childbirth
Perineal tearing from Labor & Delivery
Those of you mamas who had vaginal deliveries or attempted vaginal deliveries, this blog post is for you! Your pelvic floor/perineum goes through some fairly significant trauma and sometimes tearing in the process of bringing your baby into the world. Happily, there are SO many things you can do to help get your healing off to a great start!
Tips for Healing Your Bottom
Make “padsicles” with ALCOHOL-FREE (this is very important) witch hazel
Pour witch hazel (at least 3-4 tablespoons) on a menstrual pad and then place it in a plastic bag in the freezer. You can also add some aloe vera as well if desired, this is not required
Make many of these at once and freeze them ahead of time. Change your “padsicle” just like you would your pad each time you use the bathroom. If it feels a little TOO cold let it thaw out for a minute. Sit on a towel if it feels like its getting a little wet
These are great because you get the healing benefits of witch hazel and the numbing benefits of ice at the same time!
It is also ok to just use ice. Take as many of the perineal cold packs as you can get from the hospital. If using an ice pack from home, be smart and use a clean barrier such as a towel to protect yourself. You do NOT want an infection.
Clean your bottom with (preferably) lukewarm water using a peri bottle after peeing and pooping. You should have received one at the hospital but get another one if necessary. This will save your tissues additional “trauma” from wiping when they are sore
Self-splinting for bowel movements
Wrap toilet paper around your index and middle fingers. We want to keep this area clean and dry
Place your fingers on the area between your vagina and anus (this is your perineum) to add some additional pelvic floor support for bowel movements. The normal stretching of this muscles that occur with poop exiting your body may be somewhat painful in the early stages. This technique will help to reduce some of that painful stretching
Exhale with bowel movements (when pushing)— remember to “Blow as you go!”
Use a squatty potty (this helps you strain less on the toilet). Other step stools will work as well.
Good nutrition continues to be extremely important! Better diet = better, softer poops. Constipation is not your friend right now
Gentle transverse abdominis activations and pelvic floor “quick” flick contractions help to facilitate blood flow to this area. Good blood flow= good healing. The Expecting and Empowered App is an invaluable resources during this time.
See a Women’s Health physical therapist! While this process can be traumatic, there is no need to make it more traumatic by not getting help. Perineal tears can have profound consequences on the pelvic floor. Your scar is not only on the surface, even one session with a good PT can spare you a lot of heartache by making sure you are on the right path.
Warm bath or sitz bath for perineum (wait 2 weeks after c-section to take a full bath where you would be immersing your incision. Wait longer if your incisions still have a scab or are still healing. This will help reduce your risk of infection).
Scar massage when your scar is healed- Click here for how to do internal pelvic floor and scar massage
HEAL SAFELY + CONFIDENTLY FROM THE BIRTH OF YOUR BABY
The Expecting and Empowered App has the only recovery program you’ll need in postpartum to feel like yourself again. With 30 minute workouts designed to be done at home, you can fit them into your schedule as a busy mom.
Grading pelvic floor muscle tears
Perineal tears are graded on a 4-point scale
Grade I (skin)
Grade II (skin and pelvic floor muscle)
Grade III tears is extends from the vagina down to the anal sphincter muscle
Grade IV tear is one that involves the anal “mucosa” meaning that the tear goes from vagina to rectum.
When there is involvement of the anal sphincter, there is an increased probability that you will not have full control of your bowels. You may experience “fecal incontinence” meaning you are leaking stool. This is temporary and if it isn’t quickly resolving, you should seek help in the form of a pelvic PT.
Grade III and IV perineal tears are more severe and may need more care. Because your scar is bigger and longer (it extends from vagina to anus instead of just being around the vagina), it is going to get TIGHT.
The following exercises can women with any grade of perineal tearing, but women with larger tears may find these particularly helpful:
In a yoga child’s pose, perform 25% maximum voluntary contraction (25% “effort”) of your pelvic floor, and then really focus on your on “reverse kegel” i.e. relaxing/bulging your pelvic floor) between contractions
In yoga “happy baby” pose, do the same as above
Perform gentle TA and pelvic floor quick flicks (turn the muscle on and off). This helps pump blood flow to the area. Blood=healing
Foam rolling gluteal muscles, rolling inside of SIT bones with LAX ball
Self-stretch to your pelvic floor in side lying (grab your SIT bone and pull UP).
Give your pelvic floor a nice stretch!
In the end, the best advice we can give is to really LISTEN to body. Your body needs to recuperate and heal. Don't push through physical activities that give you pain, it is very possible to prolong your healing process by doing too much, too soon.
Women are incredibly resilient and you are no exception. Get the help you need during this time, and congratulations on making it through birth!
Need more help?
Schedule an E&E Online Wellness Session
Questions to ask your pelvic PT prior to your first appointment:
Do they blend orthopedic PT with women’s health?
Do you do an internal exam? (you want the option to have this)
Do you treat ________(fill in the blank with your problem)? — this will help ensure you can get your issues addressed!