what happens to the perineum after birth?

NADA-H

Hi ladies,

Hi, I'm pregnant with my first child and had some questions.

I have a question for moms who went through natural birth. Whether you did get an episiotomy or tore naturally or didn't tear at all what happens to the perineum area? does it sag forever after? is it possible for it to stretch beyond it's elasticity limit and just sort of break and sag? I'm a newlywed and already pregnant and now worried I will be forever ruined down there....please don't tell me that once I carry my child in my arms I won't care.

mommasteele

Oh honey! Well...in my experience, I'm back to normal. I have a barely visible scar from my episiotomy and a small amount of scar tissue on the inside but I also had to have 12 internal stitches from naturally tearing so badly. My son's head did not cone...so ouch. Anyways, it is normal to worry about how things are going to 'sit' down there and like I experienced and many women who I've talked to experienced, you go back to normal. Dr's can even give you an extra stitch to make you 'tighter'. Good luck. 

NADA-H

thanks @futuremrssteeleWed161237 how long did it take you to heal afterwards? and did you tear and got an episiotomy? 

my cousin had her baby a few months ago with an episiotomy, it's still a routine procedure here in Qatar where I live they do it before the baby crowns even!!! that's why I'm going to a private practice to have the baby with a strict birth plan, I'm not even sure they respect birth plans or have heard of them here!!! My cousin had her baby in the only public hospital here and the doctor was sewing her up for half an hour after she delivered the plecenta and she says giving birth was one thing but the cut, getting sutures, and the long recovery afterwards was way worse

aylafsu88

I had a second degree internal tear. My LO had a nuchal hand during delivery and my OB did everything he could to help reduce the tear (massage and warm compresses).  In my case it took a while to heal and I was not cleared for exercise or sex until 9 weeks. The recovery sucked and it was difficult to have sex again.  In a little bit of time things went back to normal.  I don't have any issues down there and my H says he does not notice a difference.  It is normal to worry about tearing and what could happen down there.  The big thing is to remember that it is made to stretch and you will recover.  GL!

sschwege

I can only speak from my own experience, but physically I look the same down there and DH and I don't notice a difference sexually.  In fact I think orgasims are better since having had kids, sorry TMI I know!

With my first I had two second degree tears to the side, it happened when DD's shoulder briefly got stuck.  That was pretty painful both when it happened and recovery wise.  Peeing hurt for weeks (use the peri bottle they give you) and I had random sharp pain down there for maybe a year.  The random pain I had wasn't that bad, but I couldn't believe it took that long to heal.  DH and I were having sex at 5w postpartum.  

With my second I had a second degree tear down and a first degree tear up.  I had a 'precipitous birth' with DS so I'm probably lucky it wasn't worse.  Recovery was much easier and quicker this time and DH and I were probably having sex around 7w postpartum. 

rooftop

I had a natural water birth 2 1/2 months back and did not tear at all. I look exactly the same down there other than the hemorrhoid I've been struggling with getting rid of, sorry if that's TMI. According to the midwife even that should be gone soon. GL and don't worry too much. If women's crotches were ruined from one baby we'd only ever have one and that's obviously not the case.

rooftop

Oh, and MH has mentioned me being "tighter" since healing.

wintersong

@NADA-H,
Thanks for asking the questions that the rest of the FTM (and those TTC for the first time) want to know! This is just one of the questions I never thought to think of until actually trying to get pregnant...

TobieRose

I thought I would chime in, even though I didn't have a completely natural birth with DS1. (My water broke during labor and I didn't progress, and was given the choice of c-section or pitocin. I chose pitocin and gave birth vaginally.)

I both tore and had an episiotomy. I had some long term incontinence problems that I attribute to the episiotomy, so my hope is never to get one again. Sex was painful for several months afterward--longer than I was told to expect, which was really stressful to me at the time--but that was because of a tear on my cervix. (My previous OB never told me I had torn my cervix. I only found out this pregnancy when I went into L&D for a pre-term labor scare. I am really grateful to the OB who examined me for telling me, it really helped explain things!!)

What I want to say most of all though is don't be too worried about things returning to normal "down there." I got pregnant as a newlywed too, and I have to say that once the pain went away sex was so. much. better. (Sorry if TMI ... but I think hearing about other people's experiences helps. ) 

I think things probably do change for good down there no matter what--whether you tear or get an episiotomy or none of the above--but it isn't a bad thing. Our bodies (and specifically our vaginas!) were designed to give birth, and it wouldn't make sense if they were "ruined" by childbirth. Motherhood changes you physically, and that can be scary, but it's the way things are supposed to happen!

mommasteele

thanks @futuremrssteeleWed161237 how long did it take you to heal afterwards? and did you tear and got an episiotomy? 

my cousin had her baby a few months ago with an episiotomy, it's still a routine procedure here in Qatar where I live they do it before the baby crowns even!!! that's why I'm going to a private practice to have the baby with a strict birth plan, I'm not even sure they respect birth plans or have heard of them here!!! My cousin had her baby in the only public hospital here and the doctor was sewing her up for half an hour after she delivered the plecenta and she says giving birth was one thing but the cut, getting sutures, and the long recovery afterwards was way worse

 

 

....

I had both natural tears and a episiotomy. Using the bathroom afterwards was HELL. I had to use the peri bottle they gave me for over a month. I hate how bad and scary that makes it sound but it's the truth. I think recovery was worse than my son's actual birth. I can handle a lot of pain at once (plus I had a good reason for the pain) but I am a baby when it comes to constant, nagging pains. I was cleared for sex 4 weeks later but we didn't try til maybe 7 or 8 weeks afterwards. Sex was pretty uncomfortable for a few weeks. I was much tighter and the scar tissue was EXTREMELY sensitive. But, with patience...it's like nothing was ever different. It's actually much more enjoyable now. I would still find certain positions would give us problems up to 6 months after birth but it was nothing a little slow down wouldn't help.

NADA-H

thank you for the input ladies it really does help

aylafsu88

sschwege said:

I can only speak from my own experience, but physically I look the same down there and DH and I don't notice a difference sexually.  In fact I think orgasms are better since having had kids, sorry TMI I know!

Same here.  I think it has to do with the fact that we are both really into it the few times we manage to DTD during the week!

stever

I tore badly with DS1 and went back to normal. I tore badly again, was cut, then tore some more with DS2 and I went back to normal again.

It's a valid concern, but don't worry.

NADA-H

hmmm interesting.

 

@joules235 I'm checking it out right now

thegoodpotato

I had a really bad tear with my first. I'm in Canada, and the thinking here is that it's better to let things tear naturally rather than give an episiotomy, unless the mother can't seem to push through the tear. 

They were fixing me up downstairs for about 45 minutes after ward.  They never told me the degree of the tear, but it was extensive, inside and outside.  I don't think I tore all the way to my bum.

Things actually went back to normal really quickly.  It took a good four weeks or so to feel all healed, but I was cleared for sex and fully healed by my six week checkup.  Things felt pretty much the same, sex-wise, afterward. The only difference is that there's a ridge of scar tissue in there now, but it's apparently enhancing my husband's enjoyment (sorry, TMI).

With my second birth, I had no tearing at all.  It was a walk in the park.

MississippiCatfish

Starbuck128 said:

futuremrssteeleWed161237 said:

 Dr's can even give you an extra stitch to make you 'tighter'.

No. No, no, no. I hear some backwoods doctors still perform this archaic form of torture, but it won't do anything for you. I can't believe no one has commented on this yet.

The pelvic floor muscles determine how tight a woman is down there. Adding an extra stitch in the skin to make the opening to the vagina smaller won't do anything for H and will be really uncomfortable/painful for you.

https://mamabirth.blogspot.com/2013/07/the-husband-stitch.html


Thank you. It's not about your perineum, it's about your vagina. And yes, it may feel different (looser) for him. I know that my husband has mentioned this once but said it wasn't a big deal. Several moms on my birth month board have mentioned this also. There were many moms who experienced significant pain with sex for months after delivery. I did not have that experience, but you deserve to know that's possible. Lots of lube, foreplay and taking it slow makes a huge difference.

I won't tell you it's not that big of a deal because really that's for you to decide if it happens, but it hasn't been a big deal for us. We've spoken many times about how sex is better for us now than before LO.

Eta spelling

HerbanMom

I really wouldn't worry at all! With DS1 I had an episiotomy and then tore all the way to my rectum ontop of it! Everything bounced back quite nicely no real visible scarring and it looked completely normal down there. I was having sex again around 5 weeks pp and everything felt great, which was really suprising.

When I had DS2 I was worried about tearing or having to be cut bc things wouldn't stretch but my body handled it far better and I had a small 2nd degree tear.

SO has never done anything but RAVE about how great my ladybits are after having 2 kids, he was not with me before those 2 kids. It has certainly never impacted my sex life

xnbride

It was made to stretch. Some women have more elastic skin then others but it was designed to accommodate a baby and then return to its normal state.  I have birthed 3 babes so far and all is well. Don't worry, you were made to do this!

mommasteele

futuremrssteeleWed161237 said:

 Dr's can even give you an extra stitch to make you 'tighter'.

No. No, no, no. I hear some backwoods doctors still perform this archaic form of torture, but it won't do anything for you. I can't believe no one has commented on this yet.

The pelvic floor muscles determine how tight a woman is down there. Adding an extra stitch in the skin to make the opening to the vagina smaller won't do anything for H and will be really uncomfortable/painful for you.

https://mamabirth.blogspot.com/2013/07/the-husband-stitch.html

.......

Ah, I clearly didn't think that one through. Sorry about that. I was just going off of what I had been told before.

NADA-H

thanks @joules235 I need to make both photos smaller or line them up, I'm a signature junkie, can't get enough tickers and photos and the like.

 

my gown was from Rosa Clara, it's a modern replica of Grace Kelly's and since I wear a hijab "cover my hair" I wanted something to go with the Gown so I ordered the head piece from the US, found a great online shop that does hand made custom replicas of famous veils, headpieces, and crowns for your wedding, tailored to your needs!

I will send you better pics

NADA-H

@HerbanMom so what happens when you tear from hole to hole? do you lose control of your bowl movement and such? you can't go to the bathroom for ages after? can you still do kegals and control that area if it's cut and torn?

aylafsu88

If you tear from hole to hole you still have control of your bowel movements.  A forward tear (into the urethra) does sting/burn to when you pee but it will heal and has no effect on your ability to hold your urine.  Most practitioners will perform an episiotomy if they see you are tearing badly forward.  A tear towards the back is more common. It is difficult to take your first postpartum bowel movement but they often recommend stool softeners and lots of water to help with that.

NADA-H

heck I will eat nothing but fiber and water then! that's so scare just the words tear and perineum in one sentence make me squirm

HerbanMom

NADA-H said:

@HerbanMom so what happens when you tear from hole to hole? do you lose control of your bowl movement and such? you can't go to the bathroom for ages after? can you still do kegals and control that area if it's cut and torn?

No, no permanent issues from it. I was given a stool softner at the hospital and while it wasn't fun, it wasn't an issue. Yup, no loss of control in any of that area and am still able to do kegals and nothing is "loose" down there in the least bit. Promise, your pelvic floor/vaginal walls are a muscle and they bounce back. 

I've been reading that doing squats is better for your entire pelvic region vs kegals but I've always done both.

 Trust me, SO and I have a great sex life. Try not to overthink it, our bodies are meant to do this and they bounce back remarkably well!

NADA-H

oh thanks @HerbanMom you've put me at ease. I'm less tense about it my mom keeps telling me to top looking things up so that I don't get tense about birth when it's 8 months away but I have to know everything that could happen so that I know...you know? *that sounded stupid*

HerbanMom

NADA-H said:

oh thanks @HerbanMom you've put me at ease. I'm less tense about it my mom keeps telling me to top looking things up so that I don't get tense about birth when it's 8 months away but I have to know everything that could happen so that I know...you know? *that sounded stupid*

Pregnancy can be a scary and overwhelming thing, especially the first time! You're going through alot and it's normal to be anxious, curious, confused, emotional... really anything, lol. You'll be fine though

NADA-H

I'm glad I found this website..thank you so much..I felt alone for a while but I don't anymore

HannahsHope

@NADA-H I'm glad you are feeling better. Your initial signature sentence made me be worried for you (i.e. about everyone else being excited, except you). The idea of bring a baby into this word is definitely scary. We are all here for support. Ask any questions you need

NADA-H

@HannahsHope thank you so much, I feel much better now. I have the Psychiatrist's contacts, whom I didn't end up visiting, handy just in case I feel that I'm relapsing or for any PPD, God forbid!

Whisperscloset

actually, it seems to go back together just fine..not trying to leak out TMI, but once you go back to having sex, it seems like your Va-JAy JAy is tighter to me...like it hurts more so....but i have never torn....this is my 5th one, and I can almost be clear as to the what happens next situation...good luck

Jtiki

I had a very bad tear that required over 30 stitches. I didnt even want to think about sex for about 4 months. But everything is back to normal, no visible scarring, and it all feels the same.

NADA-H

@Whisperscloset bless your heart and babies!

 

@Jtiki OUCH but in order to not have any scaring who stitched you up? the OB? or a plastic surgeon? who normally does the suturing after giving birth

NADA-H

@casey78 I LOVE you! lol your seriously my hero. thank you for sharing your story

mrsxhawkins4

With my first I had a epidural and tore very badly recovery was around 8-9 weeks. My second I did not get an epidural and I choose my birthing position so I wasn't on my back. I figured the less pressure I have on my peri the less likely I would be to stress a tear. Also I was able to control my pushing to what I could handle and I had no tears and little pain I could walk sit just fine and was up in 30 mins took a shower and healed very quickly with only some tenderness. I suggest kegals before and after birth I have had no complaints from my husband even after three children.

NADA-H

mrsxhawkins4 said:

With my first I had a epidural and tore very badly recovery was around 8-9 weeks. My second I did not get an epidural and I choose my birthing position so I wasn't on my back. I figured the less pressure I have on my peri the less likely I would be to stress a tear. Also I was able to control my pushing to what I could handle and I had no tears and little pain I could walk sit just fine and was up in 30 mins took a shower and healed very quickly with only some tenderness. I suggest kegals before and after birth I have had no complaints from my husband even after three children.

I heard about an epidural and laynig on your back making you more volnurble towards getting torn badly, which position did you choose if I may ask? they won't let you have birth here except for on your back -_- stupid

NADA-H

I managed to find a doula over here!!!! and she knows which hospitals support less intervention and which don't. I feel so relieved!

ncbelle

So to add another positive story...it is possible not to tear.  My first was 8lb6oz with a 99th percentile head - I had one stitch.  My second was 10 lbs also with a 99th percentile head - I didn't tear at all.  I do think position during pushing can make a big difference although my first was actually delivered on my back.

I'm glad you've found a supportive doula - that can make a big difference!

NADA-H

they seem to jump to "baby in destress baby in destress you need to push harder" or "you need to be cut" etc..so much while not really needed 

aylafsu88

herbabymama said:

What do you all think about perineal massage prior to birth? There is a how to chapter in my Hypnobirthing book and we discussed it in class. I've been doing it since 32 weeks and I hope it will help. Anyone else try this and think it made a difference in stretching or preventing tearing?

I never did them.  I figured they were going to be more uncomfortable for me and I did not want any pulling down there.  I ended up with a second degree internal tear.  I honestly do not think the massages would have made a difference in my case.  LO had a nuchal hand and I was pushing really hard because I wanted to be done.  My OB massaged between contractions and used warm compresses which helped but a tear was probably unavoidable. 

abirdd9

I didn't tear and my perineum looks the same as it did before I gave birth vaginally.

Athena0303

I feel really anxious about this too. I am more afraid of this than the actual labor part! I am figuring that since most women have more than one child, they somehow must heal enough to go on to have yet another kid! So when I start freaking out, I think about that...