The perineum, perineum or pelvic floor , is the area that is made up of layers of muscles and tissues, is located between the vulva and the edge of the anus . At first glance it is a skin bridge between these two areas, but it is a fibrous area that supports the internal genital organs, hence its importance in childbirth, since it can tear when giving birth.
WHAT IS AN EPISIOTOMY
Vaginal delivery puts a lot of pressure on the perineum, and that’s because it must stretch to release the baby’s head . Therefore, it is possible that during childbirth an episiotomy is carried out, which is a minor surgery , an incision in the area of the perineum that is carried out in order to widen the canal, widen the opening of the vagina to facilitate delivery.
Sometimes the laceration or tear of the perineal area occurs on its own during vaginal delivery. Both in the case of perineal lacerations and episiotomies, stitches are necessary in order to repair the area and to heal properly.
Carrying out an episiotomy will be decided by the midwife or obstetrician at the time of delivery, when the second stage begins, that is, when the baby’s head begins to be visible or we reach maximum dilation. When the episiotomy is performed, up to an additional 3 centimeters of vaginal opening is achieved . The incision will be made depending on the flexibility of the perineum, if there is not much flexibility in that area we have a greater chance of suffering a vaginal tear.
It is also possible that during the vaginal delivery we did not suffer a tear or an episiotomy was not necessary. Even so, we can notice the swollen or painful area of the perineum in the postpartum and we must carry out care that favors its recovery.
HOW TO TAKE CARE OF THE PERINEAL AREA AND REDUCE DISCOMFORT
Care in the perineum should always be carried out with great caution and in a delicate way , whatever our postpartum situation, that is, whether it has been a vaginal or cesarean delivery , as if the stitches have been necessary or not, the care they are essential as part of our hygiene and physical recovery postpartum .
– After delivery, cold compresses can be applied . We can carefully apply ice, surrounding it with a thick cloth or towel, to avoid discomfort and damage to the skin, and also to wet the points. This will help us mitigate pain and reduce inflammation in the area , but we should not prolong the application of ice for more than 10 minutes at a time. To take hot baths, we must wait at least 24 hours after delivery.
– We must always have clean hands before starting to clean the perineum area.
– It is essential to keep the area clean. We must shower daily, and pay attention and be careful with our external genitalia . We can use our usual shower gel or soap, or opt for a specific one for feminine intimate hygiene, paying special attention to postpartum points. We must also be meticulous and delicate when it comes to clarifying, since if we leave traces of soap, they can irritate the skin and feel more discomfort.
– After using the bathroom, we must be careful when using toilet paper , always wiping from front to back, and giving small touches so as not to irritate the area with dots. In this way we will avoid infections. After the bowel movements, it is best to wash the area with soap and water , always very carefully, and giving small touches with the towel to dry ourselves. Carrying out this routine we will avoid possible infections in the wound.
– We should not obsess over hygiene in the perineum area and overdo it, since our body has its own natural defenses and we could end up suffering from a vaginal infection.
– It is preferable to use cotton underwear , avoid synthetic fibers and do not use thongs. A recommended option is to wear disposable panties for the first few days.
– We must use compresses , there are postpartum compresses, called tocological compresses, which are made of cotton and without plastics , which will also help the area to perspire. We must change the compress as many times as necessary so that the perineum area remains as dry as possible, as it will promote healing.
– When sitting, we must avoid using a float, so we will prevent the points from opening, although in principle it may be contradictory, it is preferable to sit on hard surfaces . To avoid discomfort, it is best to contract the buttocks when sitting and press the back to the back of the chair . In this way, the buttocks will cushion and we will avoid tension in the perineum wound.
– It is advisable to eat foods high in fiber and drink plenty of fluids postpartum. In this way we will avoid constipation and force and notice discomfort in the perineum when we go to the bathroom.
– To promote healing, when we have less bleeding , we can place a towel or pad on the mattress and lie down, to have the perineal area in the air for a while .
– We must avoid forcing or pressing the perineum area, in such a way that we must avoid picking up weights or jumping. We can also alleviate discomfort by lying on our side and not sitting for a long time.
– It is important to rest to recover , each woman has her recovery period, take time to return to day-to-day activities, and not perform actions that can open the stitches. It is also important, in addition to other care, to wait at least 6 weeks before having sexual intercourse , to give the area time to fully recover, as well as to postpone the use of tampons.
– One of the most appropriate postpartum exercises is to go for a walk . It is beneficial for both mother and baby. Walking will improve our circulation and also does not affect the perineum area. It will also help us burn calories.
WHEN SHOULD I BE CONCERNED?
As we already said, the healing period always varies from one person to another, the normal thing is that it takes a period of four to six weeks . It is recommended that, in addition to carrying out the postpartum care routines of the perineum, we observe the area with a mirror, so we can check how the healing and healing process is going and we will observe the appearance of possible complications. We must take care of ourselves and be attentive, and go to our doctor in different situations:
– It is normal for the mother to have bleeding similar to the rule , with a fundamental difference that in this case, it will last more days . The color of the blood should be red, the smell similar to that of menstruation, and we may have clots in the staining. If we notice that the bleeding is continuous, the smell varies, we have pain in the belly or the clots are larger than the size of a lemon, we feel weak or dizzy, we should go to the doctor immediately.
– We may notice that our temperature is somewhat higher, due to the drop in milk, but we should be concerned if this fever persists for more than a day or exceeds 39 degrees .
– It is also normal to feel pain in the belly for the first 5 days because the uterus is returning to its natural size. If it persists, we must go to the doctor.
– If we cannot go to the bathroom for 4 days .
– If the perineal wound seems to open.
It is essential that we rest as much as possible, that we do not neglect our hygiene and care routine, and that we have patience in our recovery . Our doctor will tell us which painkillers and in what dose we can take to relieve pain and discomfort. We should not hesitate to ask any questions and go immediately to the health center in case we feel unwell.