Unstitched Episiotomies

[krankedyann]

My little boy turned one today. At the birth, he had shoulder dystocia, nuchal hand, and the cord was around the neck over 3 times, so I ended up with an episiotomy. After the birth, my midwife checked, and amazingly it was only a 1st degree. After discussion, we decided to leave it unstitched and use seaweed to assist in the healing process. Long story short, when ds was 3 days old, the whole household came down with the flu, and all of my help vanished (went to bed upstairs and stranded me), and I was left to care for myself, ds, and my 2 year old toddler, and I still was not even able to stand up straight. I had no choice but to get out of bed. The episiotomy ended up not healing closed more than just a tiny amount at the very bottom.

I'm at the point now that I'm wondering what and if I should do anything about it. I have really struggled with this the past year, and shed a lot of tears over it- I can't discuss it without crying still, which is why I have put off doing anything over it, or calling my midwife. What can be done without stitching? I would prefer something being done about it because it causes some problems, but I'm worried about scar tissue and the implications for future births, and recovery time now that I have two toddlers to chase around.

Can anyone give me any advice or information? I want to go to my midwife with a decent knowledge base to help in making a decision, since it's such an emotional topic for me.

Thanks

[LeosMama]

So you're saying that your episiotomy hasn't closed? You should see a midwife. Stitching isn't fun, but it isn't that horrible, either. You shouldn't have to live with this. Remember that they use stitches now that dissolve into the flesh, so they won't have to be removed. During my recovery, I felt like my stitches (2 for a small skidmark) were the least of my pain. I could feel them, but they didn't hurt as much as everything else. I'll bet it will be fine, you'll be in some pain for a few weeks (really, it may only be days), but you'll be so glad you did it.

I think you deserve to be whole and intact and to feel confident about your ability to have sex and birth a baby again.

I don't know what else I have to offer but love and hugs.

Can you please explain more about why this is so emotional for you? I'm not trying to minimize your feelings, just understand them better. From my perspective (not right, just mine), it is a physical, medical problem that needs repair. I know it is a private and special place, but that means even more that it needs to be repaired. The MW should be loving and gentle (be sure to find one that other women recommend as gentle and loving) and discreet. Please take care of yourself, mama.

[krankedyann]

I think the reason it's emotional for me is two-fold. One, I had a very terrifying birth after a very difficult pregnancy with hyperemesis and uterine prolapse. It was the absolute best birth I could have had under the circumstances, but still terrifying. I had the baby at home with a caring, competent midwife, no pain until my water broke. I am very thankful for her, because Lord only knows what would have happened had I had him at a local hospital.

Then I got abandoned by my mom who was living with us, when we all got the flu, her incuded. She went to bed and left me to care for everything, and I wasn't even able to stand up straight yet. My husband did what he could, but he had to go back to work.

Secondly, it's been a problem in my personal life. Hubby's great about it and has never said or done anything negative, but it bothers me. And I have trouble keeping in tampons. And the exposed sides of the cut are easily irritated.

I never did go for a 6-wk check-up. I was still bleeding, and they wanted to wait to do a pap until it quit, and I put it on the back burner because I was still so upset and trying to process everything.

[LeosMama]

Like I said before, I don't necessarily understand what you are going through, so if I miss the mark, keep dialoging with me.

It sounds to me like maybe you're rolling up this episiotomy with all of your other stress and trauma. This is really normal to do, but it's time to try to let go of the episiotomy as the symbol of your trauma. You need to get it healed and repaired.

Your husband sounds like a kind and gentle man, but he wants you back and needs intimacy with you, too. Men need to be held and touched and loved and the way they fulfill this need is through sex.

I don't know what to say about your mom except that you might want to try having a talk with her about all of this (maybe not your feelings about the episiotomy not healing, but about abandonment, terror, sickness) so at least it's off your chest and out in the open.

As for the actual stitching of the episiotomy, it sounds like the least of your worries. You need to get it fixed so you can feel like yourself again. You feel like you're not in control of your sex and of your life. These feelings are so common during the first year (and often longer!) postpartum and you might feel like you can get control of this by getting the tear repaired.

Even if you don't fix all the other emotional stuff that's going on, please just do it. I'm not sure what sort of research you need to do. I doubt it's going to be a big deal. It will just get stitched closed, I would think. Go to the same midwife you saw before and have her do it. Sounds like she will be gentle. Don't let her recriminate you for not taking care of it sooner, just tell her you weren't ready to have it done and leave it at that (unless she's the kind of midwife who can help you with all these emotions).

I hope this is helping, I know I'm not offering you much practical advice for the medical situation.