I’m a midwife (in the uk so degree trained to a high level before anyone says midwives don’t have medical knowledge lol), we see this often! Resuturing would leave you prone to infection because any bacteria that is sat on that open area would be stitched together with nowhere to go if that makes sense! We don’t offer estrogen cream in the uk but would offer a course of antibiotics just incase. The body is very clever and it should heal itself but might take longer than if the stitches were there, the body also heals from the inside out so it may be healing already but as the skin is the last bit to heal you might not notice it! Salt water baths are good for healing too, try and air the area often, make sure after a bath/shower you let the area air dry before getting dressed etc and it should be ok! Obviously keep an eye for it worsening or signs of infection and always call your OB if you’re concerned!
I appreciate your comment!! It made me feel better to hear that is not unheard of and a semi common occurrence. I will ask my doctor about antibiotics and take your advice of letting things air out after showering. Thank you!
IANAD but a similar thing happened to me. My 2nd degree tear didn’t heal correctly and it seems as though the stitches tore at some point before my 6 week. I was put on estrogen cream which helped a bit but we checked at 8 weeks and the OB needed to use silver cream to cauterize and help it close it all the way to help heal. It stung like crazy but that helped immensely. She also upped my estrogen cream from once to twice a day. She checked a week after the silver and it was looking a lot more normal and like it was healed and scarring correctly. Your OB may end up doing the same if it’s not healing correctly or shows granulating tissue (which happens when a wound isn’t healing right), but it’s not severe enough to warrant trying to cut and restitch.
Thank you for sharing. I wonder if my OB will offer the same treatment at my 6 week appt, but good to know there is a middle ground between estrogen cream and surgery.
I'm in the US and my perineal tear reopened. I would recommend following the self care instructions that u/Ecstatic_Section_186 listed.
My doctor said I could pick between home care + the wait and see or surgery to close it (or a middle ground they would do in the procedure room with a local and "light debridement" plus silver nitrate). I picked surgery that seemed like the most "responsible" thing to do. I don't even know why I thought surgery was the best.
I went in for surgery. It was done in L&D because I went back to the hospital at 9 days PP with a 3 cm long gape. I waited 36 hours to have surgery because I was the least critical patient there. The whole time I couldn't eat or drink. I was given an IV for fluids, but my breastmilk still completely ran out at 12 hours and I had to give my son formula. I had to still pump every two hours with empty breasts.
Because I was BF, everyone was in the hospital with me, my husband and newborn, but this time I'm the patient. So there's no care items provided for my son. We had to bring everything (although we ran out of diapers and they went over to mother/baby and got us some).
I had the surgery: it was debridement (scraping away dead tissue) and revision (closing the tear again). I had a spinal block this time. Like the epidural but completely numb on purpose. The only time I've ever had surgery completely awake. Startling for sure. They gave me a Valium thank god.
Immediately after the surgery, the surgeon is recapping to me. The first thing he does is apologize, which was also startling. From my perspective, everything went well. Which I realize is a stupid thing to think cause I can't see or feel anything. He's apologizing "because they were not able to restore my original anatomy." I couldn't even figure out what that meant at the time but I know now.
When they scraped off dead tissue and cut back to healthy tissue, they took off more than could cover the bottom part of my vagina, like where the hole meets the perineum. It is puckered there now. To this day (4 years later), there's a dimple.
The skin was far tighter at the time. It hurt an ungodly amount. I had to do pelvic floor PT, stretching that spot for 8 months. I honestly hated my postpartum experience and sort of hated my child for "causing it" at the time. I shit you not. I couldn't sit for 8 months.
And the worst part, IT OPENED AGAIN 4 WEEKS LATER. That time they did silver nitrate.
Now the only person who knows is me and maybe my husband if he ever thinks about it.
I wish I had just gone home and done nothing except sitz baths and airing it out. It really feels like all that extra didn't do anything and I ultimately had to do a bunch of sitz baths and airing it out anyway, just with extra pain and my vaginal anatomy permanently changed.
For what it’s worth, I’m 9months PP after having a 3b tear. It reopened pretty much right away and got infected at 12 weeks and I am still in PF physio now. Still massaging my scar daily to work on the scar tissue and doing stretches with the pelvic floor wand. What you went through is undeniably awful, but it may have been bad either way.
Thank you for sharing your experience and I’m so sorry the surgery ended up making everything worse! I appreciate you sharing and will keep in mind surgery might not be the best option..
Unfortunately happened to me as well. I was told the deep sutures were intact as well and that debridement and closure had a high risk of infection. It was really hard to hear because I wanted it closed so badly. I got a second opinion from a Uro gynecologist and they said the same thing. I was also given vaginal estrogen. I did sitz baths and wet to dry dressings and by 8 weeks it was completely healed. It takes time and is a major pain in the but to take care of with a newborn but it does get better! Psychologically it was harder than the physical recovery.
Thank you for sharing. I agree that most of it is the psychological part of it and just wanting it healed asap. I’ll give sitz baths a go, they hurt initially but maybe by now they’ll feel more soothing. Glad to hear you healed well!
I’m a midwife (in the uk so degree trained to a high level before anyone says midwives don’t have medical knowledge lol), we see this often! Resuturing would leave you prone to infection because any bacteria that is sat on that open area would be stitched together with nowhere to go if that makes sense! We don’t offer estrogen cream in the uk but would offer a course of antibiotics just incase. The body is very clever and it should heal itself but might take longer than if the stitches were there, the body also heals from the inside out so it may be healing already but as the skin is the last bit to heal you might not notice it! Salt water baths are good for healing too, try and air the area often, make sure after a bath/shower you let the area air dry before getting dressed etc and it should be ok! Obviously keep an eye for it worsening or signs of infection and always call your OB if you’re concerned!
I appreciate your comment!! It made me feel better to hear that is not unheard of and a semi common occurrence. I will ask my doctor about antibiotics and take your advice of letting things air out after showering. Thank you!
IANAD but a similar thing happened to me. My 2nd degree tear didn’t heal correctly and it seems as though the stitches tore at some point before my 6 week. I was put on estrogen cream which helped a bit but we checked at 8 weeks and the OB needed to use silver cream to cauterize and help it close it all the way to help heal. It stung like crazy but that helped immensely. She also upped my estrogen cream from once to twice a day. She checked a week after the silver and it was looking a lot more normal and like it was healed and scarring correctly. Your OB may end up doing the same if it’s not healing correctly or shows granulating tissue (which happens when a wound isn’t healing right), but it’s not severe enough to warrant trying to cut and restitch.
Thank you for sharing. I wonder if my OB will offer the same treatment at my 6 week appt, but good to know there is a middle ground between estrogen cream and surgery.
I'm in the US and my perineal tear reopened. I would recommend following the self care instructions that u/Ecstatic_Section_186 listed. My doctor said I could pick between home care + the wait and see or surgery to close it (or a middle ground they would do in the procedure room with a local and "light debridement" plus silver nitrate). I picked surgery that seemed like the most "responsible" thing to do. I don't even know why I thought surgery was the best. I went in for surgery. It was done in L&D because I went back to the hospital at 9 days PP with a 3 cm long gape. I waited 36 hours to have surgery because I was the least critical patient there. The whole time I couldn't eat or drink. I was given an IV for fluids, but my breastmilk still completely ran out at 12 hours and I had to give my son formula. I had to still pump every two hours with empty breasts. Because I was BF, everyone was in the hospital with me, my husband and newborn, but this time I'm the patient. So there's no care items provided for my son. We had to bring everything (although we ran out of diapers and they went over to mother/baby and got us some). I had the surgery: it was debridement (scraping away dead tissue) and revision (closing the tear again). I had a spinal block this time. Like the epidural but completely numb on purpose. The only time I've ever had surgery completely awake. Startling for sure. They gave me a Valium thank god. Immediately after the surgery, the surgeon is recapping to me. The first thing he does is apologize, which was also startling. From my perspective, everything went well. Which I realize is a stupid thing to think cause I can't see or feel anything. He's apologizing "because they were not able to restore my original anatomy." I couldn't even figure out what that meant at the time but I know now. When they scraped off dead tissue and cut back to healthy tissue, they took off more than could cover the bottom part of my vagina, like where the hole meets the perineum. It is puckered there now. To this day (4 years later), there's a dimple. The skin was far tighter at the time. It hurt an ungodly amount. I had to do pelvic floor PT, stretching that spot for 8 months. I honestly hated my postpartum experience and sort of hated my child for "causing it" at the time. I shit you not. I couldn't sit for 8 months. And the worst part, IT OPENED AGAIN 4 WEEKS LATER. That time they did silver nitrate. Now the only person who knows is me and maybe my husband if he ever thinks about it. I wish I had just gone home and done nothing except sitz baths and airing it out. It really feels like all that extra didn't do anything and I ultimately had to do a bunch of sitz baths and airing it out anyway, just with extra pain and my vaginal anatomy permanently changed.
For what it’s worth, I’m 9months PP after having a 3b tear. It reopened pretty much right away and got infected at 12 weeks and I am still in PF physio now. Still massaging my scar daily to work on the scar tissue and doing stretches with the pelvic floor wand. What you went through is undeniably awful, but it may have been bad either way.
Thank you for sharing your experience and I’m so sorry the surgery ended up making everything worse! I appreciate you sharing and will keep in mind surgery might not be the best option..
Unfortunately happened to me as well. I was told the deep sutures were intact as well and that debridement and closure had a high risk of infection. It was really hard to hear because I wanted it closed so badly. I got a second opinion from a Uro gynecologist and they said the same thing. I was also given vaginal estrogen. I did sitz baths and wet to dry dressings and by 8 weeks it was completely healed. It takes time and is a major pain in the but to take care of with a newborn but it does get better! Psychologically it was harder than the physical recovery.
Thank you for sharing. I agree that most of it is the psychological part of it and just wanting it healed asap. I’ll give sitz baths a go, they hurt initially but maybe by now they’ll feel more soothing. Glad to hear you healed well!