# Advice and Support please: 3rd degree episiotomy



## rainy32 (Apr 27, 2004)

Hi mamas. I am a brand-new (5 days old!) mom of a beautiful little boy. The birth went well, especially given that it was a rapid ( 5 1/2 hrs total) unmed hospital birth. But, Wyatt's cord was around his neck twice, and I was having trouble pushing him out, so the doctor had to use a vacuum, which necessitated a really long episiotomy.

I am scared that i will never be the same. That I'll never want to have sex, or poop (







). Though I know that the cord was the problem, I also know that I have repressed feelings in general about that area of my body, given past abusive experiences and a shaming upbringing. I feel like I let go as much as I possibly could, but somehow itwasn't enough to get my baby out safely.

I could use some support and advice on how to heal -- both physically and emotionally.

I have been doin herbal sitz baths, stool softeners have made it possible to eliminate 4 times already with very little effort, and I use lots of tucks pads to clean up. I air dry twenty minutes every day. Anything else I should do physically?

And emotionally? I have felt the area and know where the stickes are, but I can't bring myself to look. I have also tried to direct breath and energy to the wound but it usually makes me cry. Dh has been wonderful, rubbing my back and butt muscles. Any other thoughts?

THANKS!


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## Thia (Sep 26, 2004)

I had a tear between 3 and 4 degrees, so I feel your pain. What helped me the most was my peri bottle filled with water as hot as I could stand it after every toilet use. A few times a day I would add a drop of lavender eo to the bottle. It is very relaxing as well as antibacterial. Also a big help was tylenol! You may also want to try ice packs.
Remember, this isn't your fault.


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## loved (Jun 10, 2002)

Nurse your baby.
Stay in bed. Rest. Nurse - side-lying. Enjoy that baby's sweetness and being cared for by another.
Eat good, nutritious food. Drink lots of fresh, clean water.
And revel in what you have done. What an amazing birth! What an amazing mother you are!
Perhaps visualizing the scar your body is making is a warrior mark. A mark of battle to which your spirit is victorious.

Love yourself.

With love,
Lesley


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## ctdoula (Dec 26, 2002)

HUGS Mama (and congrats on your new little one)!! I had a 4th degree extension w/dd, so I can relate to what you're going through. For me, the mental part was much harder than the physical. I was terrifed to poop, etc. But, in reality, the healing process wasn't that terrible. And I can say that you eventually you will heal, have sex, poop, etc without fear. I've had minor bowel issue, but no pain/sex issue from my injury.

As for healing tips, I think tucks or any soft wet wipe will help a lot. I loved the peribottle. The hospital also gave me a numbing spray that was a MIRACLE. It took the throbbing away and allowed me to sit without pain. If you could get your hands on some of that it would really help.

Most of all, try to rest, take care of yourself, and know this wasn't your fault! Your body did a great job (just look at that little miracle). Sometimes birth doesn't go exactly as we hope or plan. This doesn't make it any less of a miracle!

ETA - crying 5 days PP is totally normal, so don't be hard on yourself. You're going through a HUGE transition right now. Also, in the past 2.5yrs since my dd was born, I've met/heard of a lot of women with tears like these. I thought I was the only one when I had dd. It's important to know you're NOT alone!! And it does get better!!


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## Bethla (May 29, 2004)

Do you have a peribottle? Try filling it with a little witch hazel and cool water to clease the area after each trip to the bathroom. Also, very hot sitz baths with iodized salt helped me tremendously.

Remember, to be patient with your body as you heal. It may take a while before you will feel up to sex. It took me almost four months.


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## liseux (Jul 3, 2004)

Congratulations!
I healed extremely well from 2 (!) 4th degree tears. (2 separate deliveries, both planned homebirths)I have this pretty figured out. When you do your sitz bath do it in the tub with just enough warm water to sit in & put your herbs in there or just do it plain. I did this 3 times a day for 3 weeks, sometimes with baby in there too. The best advice that someone else already gave you is : rest & recuperate with your bambino in bed. For at least 2 weeks, allow yourself to be waited on and do not serve anyone if they come over. Try to limit guests if you want. Don`t go up stairs more than once a day. Keep up with eating right & drink lots of water. All of these things also help nursing get off to a good start. Don`t worry about doing stuff around the house, you have the rest of your life to do that, just concentrate on healing. You will feel normal again down there! Oh & do kegels like crazy, that helps your rectal muscle get back in gear too.


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## Jessviola (Jun 17, 2003)

Rainy

I had a 3rd degree tear with my first and it took a long time to heal. At first, the most helpful things were the numbing spray (the one I was given was called Nupercainol or something like that, it's available at drug stores), lots of tucks pads on top of a menstrual pad, the peri bottle, and sitz baths. I dreaded pooping and had a really hard time of it. I'd definately keep up with the stool softeners until you're feeling more healed (but then again I tend to have problems with constipation so it could be just me :LOL). For a while it was real agony to poop.

Also, really take it easy. Even when you start to feel a little better and like you can do more. I found that everytime I started feeling better, I'd do more and then it would get worse again and I'd start bleeding heavier. This time around I'm trying to take it easier even though I only had a small tear and let myself heal more before trying to do more.

As for feeling the same, this probably isn't what you want to hear, and not what most mamas experience, but for me, it hasn't felt the same again. But not in a bad way, just different. It's tough to explain, but I feel like things are more open or exposed down there now.

It took a while for me to want sex again. We first tried about 3 months PP and it was very painful. The combination of lack of desire from nursing and pain and sleep deprivation made for a rough year sex wise. I don't think the pain lasts that long for most mamas, but it did for me. And eventually it did start to feel better and we were able to get back into the groove of things and things were as good as before









Then our biggest problem was getting to finish without dd waking up :LOL


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## Quirky (Jun 18, 2002)

Mama, I feel your pain! Episiotomies bite the big one!

I used my peri bottle every time I had to pee during the pee, to dilute it - I found the pee on my wound really hurt. I just used a big sports bottle with warm water and would squirt as much water as necessary. It also helped to have soft cloths (like cloth diaper wipes) or Tucks to wipe with - toilet paper can be abrasive.

My mom found me an inflatable blue doughnut to sit on - I guess those were standard issue back in the day when episiotomies were standard practice. That was good for when I had to sit up.

I think it takes time to heal both physically and emotionally. Don't even THINK about having intercourse until you are COMPLETELY healed inside and out - and then use gallons and gallons of lube. It took months before I felt better enough to have intercourse - dh was frustrated but understanding.

Once you do heal, you may want to do some light massaging with Vit E oil to help the scar heal.


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## rainy32 (Apr 27, 2004)

thankyou, mamas!









something really released in me after I first posted, I think acknowledging my fear and feelings of failure really helped, and TMI WARNING: I pooped very successfully and without the tears I had been shedding.







I also think my hormones are coming into wack a bit.

Nursing has been the biggest help! I literally feel myself softening as I nurse and gaze at his perfection.

And I love the idea of thinking of the scar as a warrior mark. I had wanted to birth so serenly, so calmly, and it ended up being very vocal and rapid. I had already decided to think of myself as a warrior goddess, isntead of a calm goddess -- so the scar idea really really resonated with me. Thank you for it.

Gotta go back to laying down! Boy am I lucky to have a dh who wants to and is able to wait on me for the next three weeks!!

-rainy


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## pamamidwife (May 7, 2003)

I was also cut and required a deep repair into my rectum and a subsequent perineal recontruction at 16 months postpartum.








I can only say that you should BE GENTLE with yourself. Drink lots of water, kegel and take it easy.

It's so hard to be postpartum with this sort of injury to recover from.


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## thepeach80 (Mar 16, 2004)

Congrats on the new baby! Mine is 13 days old now and I had a 3rd degree tear from a forceps extraction. I had a placental abruption and had I not been at 10 when I was, I probably would've had another c/s. I pushed and he pulled and in one ctx, Evan was out so it was fast and definitely not like I had planned either. I know it was for the best though as well. Hugs to you! I am feeling great now though and I know you will too. Let DH help as much as possible, he might not be so helpful next time.







Those first babies everyone helps out. lol Everyone has given great advice. I am in love w/ my peri bottle, I even take it w/ me when I go out! I would put tucks pads on my pad in my undies and wear them for a while. It was a nice feeling. Some moms put them in the fridge, but mine were plenty soothing at room temp. I wouldn't be in a rush to see the stitches. I have no desire to see mine any time soon. Rest and enjoy your new baby!


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## jraohc (Nov 5, 2004)

I want to thank you for posting this. I didn't even realize it was on my mind, but apparently it was.

My dd is 6 months old now. I had a 3rd degree episiotomy. They used the vacuum to get her out. DD's cord was around her neck and I was having trouble pushing her out - it might have gone better if I had waited until I had an actual urge to push, instead of yielding to the cheerleader medwife.

I'm also scared that I'll never be the same (as you can tell, this might take a while to heal!). I suppose that I've healed physically at this point, but I definitely still have emotional healing that needs to take place.

For physical healing, I think people have made lots of good suggestions. One thing I wanted to add was that I read someplace it was better to sit on harder surfaces than really soft ones. I think I decided that I agreed, although mildly padded was the best of all for me. I think it took a few weeks to stop the stool softeners entirely and I HATE taking any drugs, so I was trying to stop ASAP, but it still took a few weeks. Definitely drink enough - that was really hard for me.

Emotionally, I could use some help here too. One thing that helped was telling dh to "lay off". Fortunately he was okay with waiting on sex till my six-week appointment and didn't even mention it. I didn't realize how much I appreciated that until after the six-week appointment, when the midwife said it was okay, and then dh started to bug me about having sex. I told him I'd let him know when I was ready and to stop bugging me. That helped me a lot, for a few months. Six months later, however, he's back and he just doesn't understand why I am not ready to have sex on a regular basis. He doesn't understand why I won't let him look at me "down there". He doesn't understand why it still bugs me that I was cut.

I also have a fear that because I was cut, I will have scar tissue that won't stretch, and will need to be cut or will tear along the same cut with future births. That is definitely something I will need to work out before getting pregnant again (of course, first we need to work out the whole sex thing







).

I guess, as with all wounds, it will just take time to heal. Sorry this wasn't all that helpful to you - I wish I could be more cheerful. I want you to know that you are not alone with your feelings. It is helpful to me to know that I'm not alone and to know that there is a great group of understanding women at MDC who I can "talk" to. Good luck with your physical and emotional healing!


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## Jessviola (Jun 17, 2003)

jraohc,
I was afraid of the scar tissue not stretching also, but this time I just had a small tear and the recovery has been MUCH easier.


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## nikirj (Oct 1, 2002)

I had a third degree tear when my first was born. It took a long time to heal but once it did, it didn't give me any trouble. I had a minor tear when my (larger) DS was born.

I'd air it out for more than 20 min/day if you can. In the week or so after the birth when I was feeling really hash down there, I was doing three sitz baths a day (around 20 min each) and then laying down naked on a chux pad and sleeping/reading for a while afterwards. Even with the peri bottle peeing felt AWFUL, it was so scary how much it stung - I had a spray bottle with some witch hazel in it that I used after I peed every time I went, and it brought some relief.

It took about 4 months before I felt 'normal' down there again. I mean, the topography changed a bit, but I felt 'normal' again, could have sex without it hurting, etc. It seems like a long time, but the point is...it happened, I DID feel normal again eventually.


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## tinyshoes (Mar 6, 2002)

As my hbmw said after #2 when I had a small tear, "we have enough trouble accepting our vaginas as it is, and now this."

There has been lots of great advice on how to cope physically, and some emotional support advicce, so I'll try to add a little more of that to this thread.

During my first birth, my OB snipped me, and I experienced a lot of the same feelings you have shared, rainy32. At the hospital, I remember daring myself to touch the stitches, and I felt the prick of them, and I wanted to crumple into a heap and weep.

I couldn't dare look.

At 4 weeks post-partum, I was able to look with a mirror, the stiches had dissolved, but it was shocking to see the prominant white scar.

I think this is why birth-guru Shelia Kitzinger states simply: episotomy is the Western form of genital mutiliation

I like the idea of a battle scar, too--that's empowering and cool, and apt. But there's no denying--trauma and damage to the perineum is upsetting....._very_ upsetting.

After #2, when I had been around the block in the Messed Post-Partum Crotch Department, I surveyed the view hours post-partum with a mirror, and then frequently throughout my post-partum. All of that crotch-viewing helped 'normalize' this body part that is always hidden from my view.

My tear w/ #2 at my homebirth was a result of my initial episiotomy, and it was spooky to have the presence of my OB summoned to this homebirth...I had a lot of baggage about it, and felt the same traumas over again, but this time I think confronting my wounds, _looking_ at them, _learning_ about them, watching them heal day by day, that was an emotionally healing experience.

I'm not saying that a hand-held mirror will heal your heart, I'm just sympathizing with your sorrow. It is a HUGE DEAL. What if someone punched you in the face, and cut across the cheek? That's what it's like when a baby emerges from the stretchy yet delicate folds of a woman's body...and when a pair of blunt-tipped scissors are cutting tissues, the trauma is all the more traumatizing.

But what happens to women's perineums during birth is secret. It's not on display, like a warrior's punched face. So the secret makes it all wierd and shameful and confusing and upsetting, and I am so thankful for mdc to provide a place where we women can talk about it and remove this veil........like, for crying out loud, this is something our grandmothers and mamas should have _MENTIONED_!!!!

Perhaps as your bottoms heals physically, you can heal some of the past wounds to your psyche that you mentioned (shaming upbringing, etc.) Vagina, vagina, vagina, perineum, perineum, perineum, these are wonderful body parts that let your baby into the world, they work, they function, they will HEAL, they are cool, you use them to birth babies, and you'll use them romantically once again, sometime in the future.

You did not 'fail' your baby, it is not your 'fault' for not opening enough. As you continue crossing this bridge into motherhood, and reflect on your birth, I am certain it will become clear to you that you did a wonderful job birthing your son, and that there were no defects in what you did or didn't do. If you want, you can just take this on faith, because it is a fact.


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## liseux (Jul 3, 2004)

Definitely air it out! At night, just sleep on some cloth diapers or on a chux pad when the bleeding slows down a little.


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## rainy32 (Apr 27, 2004)

this thread is so helpful to me!

I am feeling much better physically, already -- every day I feel stronger and that gives me confidence. the more I mother my baby, the better everything is!

I would write more ... but someone needs to eat


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## nikirj (Oct 1, 2002)

Wanted to add - I sunned mine. Yes, like I was trying to tan myself down there or something. The warmth felt really nice, and UV light is protective against infection to some extent. I didn't do it for long (you don't need a sunburn down there...). At the time I lived in Hawaii and my bedroom was at a high-point, so I didn't have to worry about neighbors or anything - I just spent a couple minutes every now and then when the sunlight came through the window to the bed, laying around with my legs open to the sun. I don't know how much it contributed to overall healing, but immediately afterwards it would always feel a good deal better. Maybe just that it got warm and (relatively) dry.


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## lacysmommy (Nov 10, 2004)

I didn't have an epesiotomy, but I did tear. It was painful to do anything for a while, even pee. The peri bottle wasn't doing me much good and it hurt so bad, so I started filling the bathtub up about 4 inches and sat in it to pee. Much easier for me. I also drank some smooth move tea, but don't drink a lot of that because it works really well.

Sex still hurts five months later, and I bleed every time. It's getting easier and less painful, though. DH doesn't really get much out of it because I am cringing and crying through the whole thing. But it has gotten better, and we're finally starting to enjoy sex again. Make sure you use lube, but don't get the warming kind! It makes it worse when you have a lot of scarring, IMO.


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## jraohc (Nov 5, 2004)

I thought tinyshoes had some great thoughts - thank you tinyshoes.

I want to add two things:
1) I think I complained to my mom about the episiotomy and she responded along the lines of "of course you had an episiotomy, aren't they standard?" So, I wouldn't have expected her to have mentioned it beforehand with what little she did tell me about her labor/delivery experiences.

2) Regarding looking at and touching the wounds - that's a great idea. TMI: When we were ttc, I used to look/touch almost every day and while pregnant I was still curious how things were changing. Since dd was born I think I've only looked/touched twice in six months - reaquainting myself with my body really might help - I've definitely distanced myself.


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## tinyshoes (Mar 6, 2002)

jraohc, I'm so glad that I have shared something helpful to you. I wanted to respond to a point you brought up earlier in this thread:

Quote:


Originally Posted by *jraohc*
I also have a fear that because I was cut, I will have scar tissue that won't stretch, and will need to be cut or will tear along the same cut with future births.

I was so scared about this, too, w/ a episiotomy scar from baby #1. While pregnant with #2, however, scruitinizing the area with a hand-held mirror, I was relieved to see how stretchy and wonderful pregnancy hormones were making my tissues (incl. the scar tissue.)

During the crowning phase of my 2nd birth, I felt my bottom and was encouraged as I felt how soft and stretchy things were--imagine my suprise when I learned I had torn.









However--the coolest thing is, I now understand I had been episiotomied too tightly. The tear that birth #2 inflicted fixed what was wrong. My tear made me more normal, more like how I was before my episiotomy.

I share this because I think it clearly demonstrates the wisdom of the body, and physics. It was un-natural for my OB to mess with my bottom, and physics agreed--my ds's head wasn't going to pass thru this abnormally tight ring of skin, so it tore, and got back to normal.

The tear was not very long, and was not stiched, and healed much shorter in length than the tear (like, I didn't tear an inch and now I have an inch-long defect; those bits of tissue matched up nicely, as it was a simple tear requiring rest and keeping legs approximated.)


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