Stitches are a normal part of the delivery procedure and are commonly performed during most of the deliveries. If you are going to be a first-time mom, you have more probability of experiencing it even for a normal delivery. This is because during your first delivery, your perineum would still be pretty tight and the sudden enlargement would lead to a bit of tearing when you push the baby out.
Though this depends on how bad the tearing is, the stitches would normally dissolve on their own without leaving a scar. Also, depending on the severity of the stitches, the healing time can be anywhere between 2 weeks to a few months post delivery.
Stitches during any procedure sound daunting and especially so when you have just gone through labour pain and delivered a baby. While stitches have a rapid healing time, it can get a bit painful and uncomfortable during that time.
Here are some cases which might lead to a laceration or a tear during delivery:
• Baby with a big head or a huge baby.
• Baby in a difficult and inconvenient position during delivery.
• In case of assisted delivery.
• When the delivery happens before proper dilation of the cervix.
• Previous history of third or fourth-grade tear from a previous delivery.
• Pushing for a long time or having a rapid uncontrolled delivery.
• A shorter gap between the vaginal opening and the anal sphincter.
Normally, if the tear is superficial and doesn’t involve the muscles and tissue, your obstetrician might let it heal on its own without any stitches. However, for cases involving a severe tear or an episiotomy (a surgical incision done to widen the opening in case of delivery before proper dilation of the cervix), you will be administered a local anaesthesia and the tear will be closed off layer by layer.
Here is a degree-wise observation of the severity of the tear and the healing time of the stitch:
This is the most basic tear and doesn’t require any stitch to heal. These are superficial and involve only the outer layer of skin. Though this heals rapidly, it might result in a mild burning sensation when you urinate.
This is for tears that extend beyond the outer layer and go deep till the muscle region just beneath the external skin. Your obstetrician will stitch these lacerations layer by layer with the skin. The healing time for stitches of this kind is usually 1-2 weeks.
These are tears that are even deeper and involve the muscle around the anal region, vaginal tissue, and peripheral skin and muscles. These tears are more severe and can lead to anal incontinence and severe bleeding if not stitched properly. These stitches have a greater healing time of more than a month and can cause a lot of pain and discomfort.
These are the most severe forms of lacerations that extend even beyond the anal sphincter into the muscle region. Normally grade 4 laceration requires a small surgical procedure to close. These stitches have a healing time of more than two months and cause the most discomfort and pain.
If you have had a laceration that required stitching, you need to ensure that you maintain proper hygiene and keep it dry to avoid infection in and around the region. Avoid scratching the stitch. Try sitting in a tub of cold water with a few drops of iodine solution (or a Sitz bath). You can also try gel packs or cold compress in that region to soothe the pain. If you can’t deal with the pain, check your gynaecologist for some safe painkillers that you can take to help manage it.