Help! Torn perineum without stitches not healing!

[MamaLor]

I had a home birth almost 6 weeks ago. MW told me I had a small tear and that it would heal on its own within 2 weeks. After many phone calls complaining to her about the pain and how it was still bleeding, she finally set me up with her back up doctor. I went to go see him and he told me he could no longer stitch me up. He tore what did heal and applied silver nitrate. Gave me some pain meds and sent me out the door. Told me it should start healing up and had me come back a week later. I did. No progress. This time he told me it was due to my low iron count and breastfeeding. Said that breastfeeding lowers estrogen which is needed to speed up the healing process. Gave me some iron pills and estrogen cream to apply down there twice a day. Before dressing up, my husband had a look to see how bad it was. He said it didnt look pretty. That was two weeks ago. Yesterday he looked at again and said it still looks the same.

Advice anyone? Please help! I will be 6 weeks PP in 2 days.

[Buzzbuzz]

Second opinion time.  And by someone not recommended by your midwife.

[MamaLor]

Well, later I learn that this ob/gyn was NOT the mw's backup doctor. She was just sending her clients there to get test results.

Anyone been in my situation or had a similar one?

[Buzzbuzz]

Clearly, your midwife either (a) misdiagnosed the degree of your tearing or (b) knew you probably needed suturing and was unable to provide that service herself and just let the situation go in the hopes that it would somehow resolve by itself.

If she is a CPM, I highly doubt that she had any "backup" OB (in terms of a doctor whose practice she was officiallly affiliated with).  This doctor is probably just "midwife friendly" and, in her view, perhaps less likely to criticize her work.  Are you absolutely sure the doctor is an OB?  Some of the stuff you describe sounds rather naturopathic to me.

In any event, this is your future continence and sexual health that is (potentially) on the line.  Not sure why you're here rather than figuring out who is the best gynie in your area and making an emergency appointment.

This is not a fix-it yourself type situation.

[mwherbs]

What type of pads are you using? I would say if they are the Always brand that they may be creating or compounding a problem. stop wearing them and get a different brand and change the pad often.
I dont know why some people heal even from very large tears and others dont heal well at all stitched or not.
Without looking at it hard to give specifics, look to see if there is a varicosity, hemorrhoids, skin tags, unusual lumps or bumps... Swollen veins may respond to topical or systemic treatment with things like horse chestnut or witch hazel.
Also consider herbal sitz baths, something with a blend of comfrey leaf, uva ursi, and calendula.

If you are having sex use something like coconut oil as a lube and use plenty of it and explore positions that do not strain the area. Saint Johnswort oil is another consideration because it promotes healing and soothes pain.
I have seen the smallest cuts not heal and hurt sort of like the way a paper cut does so i would not automatically assume the mw made a mistake in estimating the degree of tear.

[liberal_chick]

I had a tear like that that healed just fine, but healed in a V (totally open).  I didn't have pain or anything, but it left me with a very small perineum so I chose to have it repaired.  I had the repair at 9 wks PP after my 2nd baby; it was outpatient and took 45 minutes.  I nursed right before I went into surgery and was good to go as soon as I woke up.  It was a painful healing process, but I'm glad I had it done.  My MW worked hard to make sure I didn't tear on the scar with my 3rd baby, and I didn't.  Everything stayed intact.

So my recommendation would be to find a good GYN who will stitch it up for you, if you want it repaired.

[eabbmom]

Oh momma I am sorry- ouchie. You can try putting some honey on your pads- soothing and antibacterial. I would see a second doctor too.

[josie423]

I would also suggest a second opinion, and ditto the honey. Raw honey is very healing.

[RockStarMom]

I would also get a second opinion from another midwife.  I'm so sorry--I had a horrific healing experience as well, due to bad stitching.  Hope you heal soon.