Four things to expect as part of your birth recovery that are the least talked about! Including our best tips to help you heal.
1. Perineal Tears
With over 90% of first time mums experiencing some sort of perineal tear or graze, it’s good to be informed of what to expect, how to recover and what you can do to help prevent a tear.
A perineal tear is the laceration of the skin and tissues that separate the vagina from the anus. There are 4 types —
- First-degree Small tears affecting only the skin which usually heal quickly and without treatment.
- Second-degree Tears affecting the muscle of the perineum and the skin. These usually require stitches.
- Third- and fourth-degree tears These deeper tears need repair in an operating theatre.
You are not alone!
Up to 9 in every 10 first time mothers who have a vaginal birth will experience some sort of tear, graze or episiotomy. It is slightly less common for mothers who have had a vaginal birth before. For most women, these tears are minor and heal quickly.
Treatment & Management
- Put ice or a cold pack on the sore area for 10 to 20 minutes at a time.
- Sit in 8 warm water with sitz salts for 15 to 20 minutes, 3 times a day and after bowel movements.
- Keep the area clean by pouring or spraying warm water with a perineal wash bottle over the area after you use the toilet.
Prevention
There are a few things that can help prevent or reduce your chance of tearing.
Before Labour —
Use perineal massage. Doing perineal massage at home at the end of your third trimester also may help the tissue stretch more easily during labor. During the pushing stage of labor, a member of your healthcare team can also help with this.
During Labour —
Keep the perineum warm. Use a warm, damp cloth or heat pack on the area during the pushing stage of labor may help the tissue stretch more easily.
Control your pushing. Aim for controlled, consistent pushing and listen to your body when it tells you to push. Pushing gently and slowly can give the tissue time to stretch.
If you're concerned about vaginal tears during childbirth, talk to your healthcare professional. Ask what the care team does to prevent vaginal tears. Talk about what you can do to help prepare for delivery and lower your risk of tears.
2. Postpartum Bleeding (also known as lochia)
Whether you’ve had a vaginal or c birth, you can expect a lot of vaginal discharge and bleeding in the days and weeks after birth. This discharge, called lochia, is a mix of mucus, blood and the uterine lining.
What To Expect
It is typical for lochia to continue for 4 to 6 weeks, sometimes even longer. It will be bright red, heavy, clumpy in the first week after birth and then subside to lighter, watery consistency as the weeks pass. Expect to use a lot of maternity pads (regular pads just aren't up to the task for this) and be sure not to use any tampons or period cups to avoid risk of infection.
Treatment & Management
- Help relieve the cramps with a heat pack
- Use organic cotton maternity pads to avoid irritation to an already sensitive area
- Rest and give your body time to heal
When To Worry
It’s rare but postpartum haemorrhaging does happen. Signs include bleeding through one to two pads per hour, pale skin, shakiness and chills. If you or your partner notices these symptoms, at the hospital or in the first 45 days after delivery, you should seek medical attention immediately.
3. Diastasis Recti Abdominis (aka abdominal separation)
Let’s discuss Diastasis Recti Abdominis (aka abdominal separation) — what is it? How does it happen? And what to do, if it does?
Abdominal separation occurs when the connective tissue that joins the rectus abdominis muscles in the midline of the abdomen becomes stretched and weakened, causing the muscles to separate.
☝️This can occur during pregnancy or after.
The Good News?
You are not alone! Two-thirds of pregnant women develop some degree of diastasis recti, especially in the third trimester. It’s common but also easily treatable.
So, How Do I Know If I Have It?
If you can feel a gap of two finger widths or more, schedule an appointment with your primary care physician for a definitive diagnosis.
What Can I Do If I've Been Diagnosed?
In many cases, diastasis recti resolves itself after your baby is born. However, it is not uncommon to need physical therapy to help you heal.
4. Your First Postpartum Poo
You’ve just had a baby, everything hurts and now you have to poop?! Whether it’s been hours or a few days, it’s a daunting moment after birth but there are a few things you can do to make the first bowel movement, and the ones after, a little easier.
Breathe
Breathe and slow down the fear, anxiety and nervousness. Avoiding a bowel movement can make the situation worse and could lead to more pain and discomfort. Don’t force the movement
Don't Wipe!
Use a perineal wash bottle and gently dab. Wiping is not recommended after giving birth vaginally. Even if no major tears were sustained, the area is likely to be quite inflamed and tender, and rubbing it — even gently — with dry toilet paper is not ideal.
R.I.C.E.
Rest, Ice, Compress and Elevate. Using ice, gentle compression and remembering to put your feet up and rest will help the tissues heal which will help make bowel movements less painful. RICE for the pelvic floor can be done by resting as much as possible, applying ice to the perineum with the gentle compression of an undergarment or sitting on the ice and elevating your feet when possible.
Hydrate
Rest, Ice, Compress and Elevate. Using ice, gentle compression and remembering to put your feet up and rest will help the tissues heal which will help make bowel movements less painful. RICE for the pelvic floor can be done by resting as much as possible, applying ice to the perineum with the gentle compression of an undergarment or sitting on the ice and elevating your feet when possible.
Soothe
Sitting in sitz bath salts can help to soothe the area relieving pain and inflammation, especially if you have haemorrhoids.
Posture
How you sit on the toilet can make all the difference. Here are some tips from @theroyalwomens
- Lean forward when you sit, placing your elbows on your knees. Relax your stomach.
- Place your feet on a footstool, making sure your knees are above your hips.
- Exhale deeply, sigh or hiss as you make a bowel movement. This helps improve your breathing and the goal is to not hold your breath.
- Hold your stitches with your hand and a pad or toilet paper.