2nd degree tear - scar still bothering me at 21wks pp

[Attila the Honey]

I had a 2nd degree tear from the OB attempting to hand deliver the placenta. My baby is now 21 weeks old and I can still feel this scar all the time. It doesn't hurt, but it bothers me alot - feels almost like a mass. I am just constantly aware of it (but there is no soreness). When I actually touch it there is no mass, but the scar feels very firm.

When I went for my 8wk checkup with my midwife I asked her to check it and she said it looked really good, healed well. I told her it bothered me and she agreed that it was firm. I never had a chance to really ask her what I could do or if this is just the way things are because another complication took our attention away from the scar. (retained placenta)

Is there anything that can be done about this? Will it become less firm with time? Is this just how life is after having a tear in your perineum??

(On a sidenote: I had wanted to go back and see my midwife again, who I really like, but she works in an office with OBs and they won't allow me to see her. In that practice the midwives handle only the most run of the mill non-complicated situations, and the moment I was diagnosed with a retained placenta and given an emergency d+c at 9wks I was booted over to the doctor's service. The only way I will be seen at that office is to be seen by a doctor, and I absolutely refuse. I had the misfortune of dealing with 4 of the 5 OBs there, never again. It breaks my heart because the midwife I had was wonderful and I know she could and would help me so much. But, I digress... back to my perineum... :LOL )

Is there anything that can be done to make this scar less firm and annoying?

[TurboClaudia]

Ask for a referral from the OBs (or just do some research and find someone on your own) for a physical therapist specializing in pelvic floor rehabilitation and myofascial release. They are specially trained in all things pelvic floor, including vaginal pain, uterine prolapse, urinary bladder prolapse, and perineal tear healing. I have personally met two women in the past two years who do this work and their education and knowledge about the biomechanical and structural aspects of the female body are absolultely amazing. They will definitely have therapies and suggestions for you.

warmly,
claudia

[Attila the Honey]

Is there a step before finding a physical therapist? Something I can try at home first? Could it just need time to loosen up? I have to be honest, I am not really relishing the thought of having physical therapy on my perineum!!

[seraph]

My DD got me with her fist on the way out, I had stitches and I was uncomfortable for a while postpartum. I too healed well but anytime we tried to get intimate it took a lot of time and patience and lubricant for me to be comfortable. I started massaging it with Babeotanicals Perineum Power oil and it softened my scar and helped immensely. You could massage with any good carrier oil, or infuse it with comfrey or other herbs for healthy skin.

[tinyshoes]

Originally posted by TurboClaudia
Ask for a referral from the OBs (or just do some research and find someone on your own) for a physical therapist specializing in pelvic floor rehabilitation and myofascial release. They are specially trained in all things pelvic floor, including vaginal pain, uterine prolapse, urinary bladder prolapse, and perineal tear healing. I have personally met two women in the past two years who do this work and their education and knowledge about the biomechanical and structural aspects of the female body are absolultely amazing. They will definitely have therapies and suggestions for you.

warmly,
claudia

AMEN!

I am currently seeing a pelvic floor specialist for my slack pelvic floor, and it's GREAT.

I was hesitant to see this occupational therapist, however, because I didn't really understand what she could do for me, and it seemed like a lot of screwing around to get a referral, do I really need to see an OT for this, etc., etc.

My CNM gave me the name of an OT that she likes and has worked with in the past, I went to meet w/ this OT, and discovered all the wonderful things Claudia just raved about.

My OT reminds me A LOT of my homebirth midwives and my CNM...sweet, caring, calm, and knowledgeable about women's bodies and how to help a woman have her body working optimally.

An OT is a great person to see for your prob because ALL that woman does is look at various healed bottoms all the live-long day. They seem to be staunch believers in the power of the pelvic floor that is constantly degraded by things that happen in obstetrics (episiotomies, no one listening to a post-partum woman's needs.)

My OT just went to some OT conference and she spoke of a wonderful world-renound pelvic floor therapist from Australia who said that in Australia, it is common procedure for new moms still in the hosptial to have a visit from a lactation consultant AND a pelvic floor therapist! The idea being, yeah, breastfeed your kid, and yeah, do some Kegels to strengthen your floor/here's how your bottom will heal.

My personal experience with "physical therapy" on my perineum thus far has included a manual evaluation by my therapist on my first visit (no worse than anything that happens at the OB/GYN, and actually much more pleasant, as my therapist sits up by my head on a stool, rather than between my legs.

The next visit included little biofeedback pads attached to wires attached to my OT's computer--this is definitly the 'scary' part of seeing an OT, but hey--the process of placing the little pads (smaller than a band-aid) near the buttcheeks is the 'worst' part, and then the electrical impulses created by my muscles when I kegel show up in graph form on the computer screen, LIVE, so I can see how to best work my muscles, and so that there can be a way to measure improvement (and modify the prescribed exercises, if neccessary.)

Even though I was in for my weak pelvic floor, she spent time evaluating my episiotomy from birth 1 (delibrate equivilant to 2nd degree tear) and a tear from birth 2, to make sure they weren't borthersome for me.

I think it's very valuable for a woman to spend time on an important part of her body with someone who is specifically trained to honor that area of anatomy.

[TurboClaudia]

I don't know of any remedies of massage you can use for yourself to help with the healing, but I do know that one of the PTs I met actually saw one of her professional acquaintances after the birth of her daughter when she experienced discomfort during intimacy. She said it was a unique experience to see it from both sides: client and practitioner.

And thanks for the personal testimony, tinyshoes! I have not used this kind of therapy yet (expecting our first late this spring!) so I don't have the benefit of memory to describe the methods they use. I can only reiterate that the pracitioners I've met have both been very calm, kind, gentle souls with a lot of knowledge and a willingness to listen. We need more of them!

warmly,
claudia

[Tanibani]

Tinyshoes, thanks for sharing! I have a very weak pelvic floor and was thinking about surgery at some point : which I would rather NOT do to help it (far off in the future when I'm done having kids.)

Attila the Honey, I'm so sorry to hear about your scar. I suffered a 2nd degree tear (vagina) and 3rd degree tear to my anus (there is a bump there from the stitching!) Anyway, I had bad constipation for 3 years because of the bump/scar... it was literally an obstruction. It was very distressing for me. I saw a Chinese Acupuncturist and he took care of that! (I also noticed that when I was feeling very angry, I couldn't "go.") Plus my incontinence - which I have had all my life. But then I stopped seeing him when I got pg.

Anyhoo, I don't feel pain at the 2nd degree spot really... only when I'm EXTREMELY angry or stressed. I felt that way about a month ago at DH. I was so upset with him, I was trying to take a nap and I could feel my scar SPASING!!! Weird! Very rarely I'll feel my scar twitch... and it's usually emotionally related with me.

I'm wondering if you have any unresolved issues surrounding the birth. It has only been 21 weeks. Pehaps that's why it's "acting up." But I really have no clue. I was furious with both my OB and DH for almost 2 years because of the tear. Which caused other problems in my body. Thankfully I have let it go.

[KiwiZ]

I had a 2nd degree tear from my VBAC. When I looked at how I had healed I noticed an area that looked kind of like a crater. At my 6 wk pp check up they said it would heal "from the inside out" and not to worry about it. So I forgot about it.

While making love, that area felt tight but I figured it would heal with time. At 5 mo pp, I checked it and it looked the same and the perineal area felt tight to me. I called my OB/GYN and made an appt. I totally stressed about it cuz I feared surgery.

Sure enough, they did have to numb the area with lidocaine(I think?) and cut away the scar tissue. It didn't hurt except for the initial sting of the shot, was nowhere near as bad as I thought it might be. It healed smooth and my perineum is flexible again

I know its scary but I would recommend at least consulting with an OB/GYN. When I told them how anxious I was, they were very gentle and reassuring for me and made it a much better experience.

Best of luck

[aircantu1]

Is pelvic floor therapy safe while pregnant?

I have been diagnosed with vulvar vestibulitis and my OB gave me a referral for pelvic floor therapy, but I have terrible insurance and it would have been expensive...and since I was very skeptical of physical therapy solving my problem, I just put it on the back burner. Now I'm rethinking my attitude and think it might work after reading this thread...but I'm pregnant again so I don't even know if it's something I could/ should do at this point.

Would it make sense to go through all that to heal the pain, just to deliver another baby and probably tear again...

I've had the vulvar vestibulitis since before getting pregnant the first time, I just didn't have the diagnosis that soon. But, I had a 2nd degree tear from having my son and definitely developed a new and different pain from that...it seems to have healed somehwhat, but it still isn't 100%.

[scheelimama]

aircantu1,
I'm not really sure about whether it's safe or not (seems to me like it would be fine, but not an expert here), but anyway, I just wanted to say that if you did do pelvic therapy and strengthened that area, there's a good chance you wouldn't even tear next time. KWIM? The stronger your pelvic floor, the better chance you have of not tearing. Anyway, just a thought.

[copslass]

Attilla the Honey,

That stinks. I'm sorry you're feeling discomfort. After my second cesarean section, which was a "classical" (vertical) incision, my scar formed a painful keloid, and 14months pp I saw a plastic surgeon, who injected cortisone directly into the scar. OUCH! I had to have several injections a week apart. It was painful, but afterward, my scar softened and was no longer painful.

I had a friend in LLL who had the same procedure for a painful episiotomy scar. Worked well for her, too.

Wishing you well,

[aircantu1]

Thanks everyone!

They will treat me while pregnant, and I have my first appointment June 1st. I'm so excited. I really hope it helps.

[tinyshoes]

Originally Posted by aircantu1

They will treat me while pregnant, and I have my first appointment June 1st. I'm so excited. I really hope it helps.

That's great! Stong pc muscles and a happy vulvar area will help you have a wonderful, aware birth experience!

[TurboClaudia]

I'm so glad that you have decided to give this therapy a try! I hope it makes a world of difference for you, and if you feel comfortable, please let us know how it is going.

warmly,
claudia