Childbirth, tear or cut - What will happen?

Tears and cuts (episiotomies) are repaired with stitches. Most women recover quickly, but you may be sore for a few weeks while the wound heals. You may find sex uncomfortable or even painful for some time.

If during childbirth you've had a tear or your doctor or midwife has made a cut, you will probably need stitches.[1] Stitching closes the wound and puts your skin and muscle back together in the right place to help it to heal quickly.[1]

Midwives and doctors are trained to stitch tears and cuts. They usually do the stitches as soon as possible after your baby is born. You'll probably stay in the delivery room. You'll have an injection (local anaesthetic) to make the area numb so the stitching won't hurt.

If you've had a bad tear (third-degree or fourth-degree), you may have to go to an operating theatre. (To read more about the types of tear, see What is a tear/episiotomy?) In the operating theatre, you may be given a drug to make you sleep (a general anaesthetic) or you may be given a painkilling injection just for the lower part of your body (an epidural).

Most women heal within a few weeks of having stitches.[1] But in the meantime:[2] [3]

You may feel sore. More than a quarter of women are sore for up to two weeks.
It can hurt when you have sex
It may hurt when you pass water (urinate).

Every time they see you, your doctor, nurse or health visitor will ask if you're in pain or discomfort.[4] If you're worried for any reason, they'll offer to check how well your cut or tear is healing. They may recommend an ice pack or cold gel pack, as these can help reduce pain.[4] Taking paracetamol can also help.

If ice packs and paracetamol don't help, you may be prescribed ibuprofen or a similar drug.[4] (Drugs like ibuprofen are called nonsteroidal anti-inflammatory drugs or NSAIDs.) You may get these as pills or as suppositories (tablets you put into your back passage).

Your nurse or health visitor may also give you advice about keeping your wound clean. You should change your sanitary pads often.[4] It's a good idea to wash your hands before and after changing your sanitary pad.

To help with any discomfort you also could try:[5]

Warm baths (these will also keep your wound clean while it heals)
Loose, comfortable clothes
Herbal remedies such as arnica or calendula cream.

There hasn't been any research on these simple treatments, but some women say they help.

Most women feel better quite soon, especially if they've had a small or medium-sized tear (first-degree or second-degree tear). But in one study, about 1 in 10 women were still sore after three months, and 1 in 6 said it still hurt to have sex.[6] In another study, about 1 in 10 women said it still hurt to have sex one year after a small or medium-sized tear.[7] [8]

If your problems drag on, they can make you miserable, stop you from breastfeeding and interfere with your social life or sex life.

Bad tears can make you feel worse for longer. If the tear extends backwards into the ring of muscle around your back passage, you may have trouble controlling wind or you may leak small amounts of loose bowel motion (liquid stool).[9] [10] If this happens, you may need further treatment. Your midwife, health visitor or family doctor will be able to help.

References

Fleming EM, Hagen S, Niven C. Does perineal suturing make a difference? The SUNS trial. British Journal of Obstetrics and Gynaecology. 2003; 110: 684-689.
McCandlish R, Bowler U, van Asten H, et al. A randomised controlled trial of care of the perineum during second stage of normal labour. British Journal of Obstetrics and Gynaecology. 1998; 105: 1262-1272.
Glazener CMA, Abdalla M, Stroud P, et al. Postnatal maternal morbidity: extent, causes, prevention and treatment. British Journal of Obstetrics and Gynaecology. 1995; 102: 286-287.
National Institute for Health and Clinical Excellence NICE clinical guideline 37: routine postnatal care of women and their babies Available at http://www.nice.org.uk (accessed on 31 July 2006)
NHS Direct Online. Health Encyclopaedia: episiotomy. Available at http://www.nhsdirect.nhs.uk (accessed on 30 January 2006).
Kettle C, Johanson RB. Absorbable synthetic versus catgut suture material for perineal repair (Cochrane review). In: The Cochrane Library, Issue 1, 2006. Wiley, Chichester, UK.
Mackrodt C, Gordon B, Fern E, et al. The Ipswich Childbirth study: 2. A randomised comparison of polyglactin 910 with chromic catgut for after birth perineal repair. British Journal of Obstetrics and Gynaecology. 1998; 105: 441-445.
Grant A, Gordon B, Mackrodt C, et al. The Ipswich childbirth study: one year follow up of alternative methods used in perineal repair. British Journal of Obstetrics and Gynaecology. 2001; 108: 34-40.
Sleep J, Grant A. Pelvic floor exercises in postnatal care. British Journal of Midwifery. 1987; 3: 158-164.
Sultan AH, Kamm MA, Hudson CN. Anal sphincter disruption during vaginal delivery. New England Journal of Medicine. 1993; 329: 1905-1911.

Glossary

local anaesthetic: A local anaesthetic is a painkiller that's used to numb one part of your body. You usually get local anaesthetics as injections.
general anaesthetic: You may have a type of medicine called a general anaesthetic when you have surgery. It is given to make you unconscious so you don't feel pain when you have surgery.
epidural: Layers of tissue cover your brain and spinal cord. The epidural space is the space between two of these layers. Before surgery or a procedure, you may be given pain medicine in the epidural space of your spinal cord. You'll have no feeling in your body below where the medicine was injected.
NSAIDs: NSAID stands for nonsteroidal anti-inflammatory drug. NSAIDs help with pain, inflammation and fever. They are called 'nonsteroidal' because they don't contain any steroids. Aspirin and ibuprofen are both NSAIDs.

This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.