How to heal your scars after an episiotomy or tear during childbirth
While childbirth is one of the most wonderful abilities we have been given, it’s also one that can come at a physical cost. Once you have your new baby it’s important to focus on what’s important – that they are safe and well. But it’s also important to consider your own wellbeing and do what you can to make yourself feel physically and mentally well.
Why might you need an episiotomy?
An episiotomy is a deliberate incision made by the doctor or midwife during childbirth. It's a small diagonal cut from the back of the vagina, directed down and out to one side. It makes the vagina wider, allowing for your baby to be born more easily. The cut goes through the skin and muscles, and is similar to a 2nd degree tear. Episiotomies are not done as standard in the UK but are sometimes an option if your baby is suffering from foetal distress and needs to be delivered quickly or if you are at risk of a severe tear. While hopefully not severe, some of sort of tearing is actually quite common, with the NHS reporting that up to 90% of first-time mothers who give birth vaginally will experience some sort of tear, graze or episiotomy.
How can you reduce your risk of tearing or episiotomy
Massaging your perineum during late pregnancy, after 34 weeks, can
reduce your risk of tearing or needing an episiotomy. Pelvic floor
muscle exercises, in combination with massaging your perineum, can also reduce your risk. Consult with your midwife or women's health physiotherapist to ensure you know how to do it correctly to achieve the best possible results.
Coping after an episiotomy or tearing
Scar tissue around the area where you have had an episiotomy or suffered a tear can become quite tight and painful and may become attached to the layers of skin around it. This can cause discomfort during urination, bowel movements and intercourse as well as during general activity.
Postnatal perineal scar tissue massage
After you have had your GP postnatal check-up at around 6-weeks to ensure any stitches have healed and there is no sign of infection, you can begin postnatal perineal scar massage to reduce the scar tissue, soften it and ease discomfort. A women’s health physiotherapist can help you to understand your body and overcome any fears about touching the scar, as leaving your scars alone is actually the worst thing you can do! During your Mummy MOT, your women's health physiotherapist will show you how to correctly perform a perineal scar tissue massage, to ensure that the scar stays flexible and pain free.
You may be experiencing redness, heat and swelling in the area, but as long as your GP postnatal check has been done and you have been given the all clear, it’s ok to continue.
Always begin by washing your hands to prevent the transfer of any germs or infection, and have a hypoallergenic, water based lubricant available. You should start externally around the tear, carefully working your way towards the torn site and even internally if you have scar tissue or discomfort there too. Try following these simple steps:
- Apply lubricant to the opening and your thumb
- Start externally. Apply pressure with your thumb or fingers and firmly massage into the scar, along the line of it, across it and in circles over the scar.
- For internal stitches, make yourself comfortable with your legs gently open. Insert your thumb into the entrance of your vagina so the pad of your thumb is facing down towards the anus. Gently press down and hold for 30-60 seconds
- Move a little to the left and repeat
- Repeat to the right
- Press firmly with your thumb on the back of the vaginal opening and make firm ‘u’ shapes over the scar tissue.