It is common to experience a tear/bruising to your perineum (the area between your vagina and rectum) when you have your baby.
Tears vary in size and depth. They can be inside the vagina, on the labia, or on the perineum. They are assessed by looking at your perineum, assessing how much blood loss there is and doing a gentle vaginal examination. This will be done by your midwife or obstetrician after your baby is born and the placenta has been delivered. You will be offered gas + air for this if you need it. You will also be offered a rectal examination to check there is no damage to your bowel.
These examinations are offered even if there is no obvious tear, as damage may not always be visible. Your consent will always be obtained before any procedure.
Tears can be:
You may experience one or more grazes or tears to the labia (vulva). These can often be left to heal naturally, depending on their size, position and if they are bleeding. Your midwife will advise you on this, and how to take care of the injury.
Not all tears require stitches – it will depend on your personal circumstances. You will be advised to have stitches to repair an episiotomy, tears that involve the muscle layer, those that are bleeding, or if the alignment of the tear needs adjusting.
Dissolvable stitches are used so that you do not need to have them removed. These can take up to six weeks to dissolve, and you should speak to your midwife if you are having any problems or pain associated with your stitches.
3rd and 4th degree tears are repaired by a senior obstetrician/specialist in theatre with a spinal anaesthetic.
Your midwife will ask to examine your stitches when competing your postnatal checks. This is to check that you are healing and haven’t got an infection or any swellings which could need treatment. She will always ask for your consent before examining you. You always have the right to decline examinations. We understand that checking your stitches is very personal, and the midwife will make it as private and comfortable as she can for you. If you feel anxious about these examinations, talk to your midwife about how you are feeling.