Will I ever completely heal from my dd's birth?

[KarinaGrace]

First, a bit of background: My first dd was a great home birth, I had no tearing and felt 100% within a week. It was soooo easy. I thought all of my births would be that way. Well, my second dd was not as easy. It was a very quick 3 hour labor, and we couldn't reach my midwife, so it ended up being a UC. It would have been wonderful, but I didn't have time to get in the water and ended up with a tear because she came too fast.

When my midwife finally showed up 12 hours later, she looked and the tear and said it was first degree and would take 2 stitches to close it up. Then she said that it didn't really need stitches, it was perfectly lined up and should heal quickly. Since it had been so long since the birth, everything was feeling really raw and I was tired, so I decided not to have it stitched.

During the next week, I was incredibly sore and could barely move. I couldn't believe that on small tear could cause so much pain, but every time I called my midwife she told me it was normal. She acted like I was making too big of a deal out of it. She checked it at 2 days and 2 weeks, and said everything looked great. Well, at my six week appointment, she checked and realized that it hadn't healed correctly. Just inside my vagina, at the bottom, I had a skin tag where the edges of the tear hadn't lined up quite right. It was like raw skin and very painful. She told me that it would be fine, it would just take a month or two for that skin to get used to being outside of my body.

It continued to be painful. At 3 months postpartum, the skin tag fell off and finally things started to heal completely. There was a large painful knot under the skin where it had healed wrong. It's now 6 months later, and while it looks completely healed, there is still a little knot that hurts. I am constantly aware of the area during the day. It feels a bit pinched, like the skin is stretched too tight. The area isn't very flexible, and it's uncomfortable during sex. I wouldn't say that it hurts anymore, just that it can be uncomfortable.

I struggle with this every day. I keep thinking back to dd's birth and all of the things I could have done differently. If I had realized she was crowning, I could have slowed down. I could have jumped in the tub. I could have used warm compresses. And I could have had it stitched. I'm really angry at myself. I feel like this was preventable, but I messed it up and now I have to live the rest of my life with it. DD 2 had a smaller head than DD 1, so I really don't think this needed to have happened. I'm now not sure if I want more kids, because I'm afraid it will happen again and I don't think I can handle that.

Since the birth I've moved, so I no longer have access to my midwife (who I don't trust any more anyway) and every doctor that I try to get into either isn't accepting new patients or only offers appointments 4-5 months out.

So, do I have any chance of this getting better, or is this just how it is now? I feel like I shouldn't still be having issued with a 1st degree tear 6 months out. I was just wondering if anyone had a similar story or words of wisdom. If you've read this far, thank you.

[beansavi]

Okay, the main 2 things I want to say to you are:

1. DO NOT be angry with yourself. You were a laboring monkey and you did not do anything "wrong" in labor. Imposibe! I pushed against the advice of my midwife, and it turned out ds needed to come out fast anyway... she had underestimated my amnioic fluid and it was barely there! My water broke in a tiny splish as he came out. Our instincts are perfect and wonderful.

2. You do NOT have to live your life with that pain every day. The tear did not heal perfectly -sometimes that happens to ALL creatures- and therefore it can be fixed. You are worth it. Go to whoever you have to to get it fixed.

Hugs,
Bean

[KarinaGrace]

Thanks. I need to hear that. On one level, I know I'm being completely ridiculous, but I can't help it. What could they do to fix it? That skin is gone, so I'm really not sure what could be done. I'm also terrified of any more pain, so I'm not sure that I'm emotionally ready to go there.

[jacquelinej11]

[hugs] I don't have any advice or anything but I had a small tear when DS was born and it's still healing (they didn't give me stitches cause they said it wasn't bad at all) but I have a knot feeling too (but I'm only 5 weeks PP).

I've only had one but they say every birth is different I think you could have another one as long as you have the love and support from friends/family

[Bibicaffe]

Every woman should insist on stitches. I think we get frightened by horrid happy husband stitch stories and the like. And that is absolutely justified. But stitches serve a VERY good purpose. And if you have faith in your care provider, which we of course always should (I sadly myself did have a midwife I didn't trust, so BTDT ). Then for heaven's sake either let them stitch you or insist that they stitch you. I think we get so proud of how awesome our bodies heal themselves, that we forget the simple logistics of how much things move around "down there". I know some women have healed perfectly with no stitches. And yay for them. And some women have suffered terribly from their stitches, for them. But truly, to pick a blanket statement, I would say that if you trust your Doc GET stitches. Even if it's just the 2 of them. I am so sorry about your experience. I had the same issue, my midwife just thinking my skids and tears were no big deal, and I was trying to tell her I could FEEL that they were. I think it can be tough for them though too. We are all so different in regards to our vulvas and vaginas. Our shapes, our folds, they vary. It must be difficult to know what is not "normal" for *that* one, ykwim? I hope you get better very very soon. And I know your fear. after the birth of my third which left me feeling really raw and torn, I would just hold myself and cry and cry. I DID NOT want anymore babies coming out of MY vagina again! EVER, But actually here we go for #4, so, yeah, it'll get better.

[KarinaGrace]

I wish I had gotten stitches. I kick myself every single day for it. Part of what makes me so mad is that normally I would have gotten them, but it was long enough after the birth that nothing was numb anymore, it was really raw and sore, and I was exhausted. It seemed so easy to agree at that point. By the next day, I regretted it and it was too late.

I'm still upset with my midwife, who decided that she had to go camping with her family that weekend even though I was 41 weeks pregnant and her only client due for 3 months. She said "Oh, I though I had cell phone reception." Well, she didn't.

[olive&pimiento]

Many times these things get better as baby nurses less and a mother's hormome levels return to a non-lactating state. Estrogen gives the tissue more elasticity. I think you should have it looked at by a professional before you give up on any more children. I think your midwife acted very irresponsibly, and I am not saying this to pass judgement on someone who's side can not be presented here, but only because I think you need to know that there midwives out there who will give you great care. Having another baby does not have to be a repeat of the last experience. Good Luck.

[Kat_shoshin]

Get it fixed - for you.

Here are two stories for you:

I had bits that were in pretty bad shape - Episiotomy and 3rd degree (they kinda go hand in hand). But I had this bit that was stinging when I peed.

Well I did get it checked at my 6 week apt and he said that it was a little open wound that he would cauterize. He did, and it still really hurt for a long while, but I did have pain free sex at 6 months post partum. I asked when I would feel normal, I was told I would find my "new normal" and I have.

It's funny, I never thought to take a before picture to compare - it's the sort of thing you don't think would would really want, but I kinda with I did.

My cousin, on the other hand, had 4 relatively easy-ish births, and then her 5th child needed a couple of hands up there to help turn/move her on her way out - not sure of the details. Fast forward 10 months and something doesn't feel right. Then she found that she could no longer use a tampon... apparently there was a tear in the back wall of her vagina that never healed. She got reconstructive surgery - and her tubes tied, after the birth of her 6th and last child. She said she has felt never better and was really glad she got that corrected because it had bothered her for the years in between.

[whoziwhatsit]

Sorry you are having a hard time dealing with this. That's really a lousy thing your midwife did. I had a second degree with #1 and still can feel exactly where it was. There is a line of scar ending in a knot. I tried not to blast him out, but he did anyway before his shoulders rotated. Try not to beat yourself up about it. It sounds like you really needed some guidance during your birth and didn't get it. This is not your fault. I imagine you must have been pretty scared and anxious about reaching her.
Anyway. You should get this looked at and fixed if you want to. I have a friend who, like you, could not stop thinking about it. She finally went to see a female doc, who kind of shrugged it off, told her it was no big deal and that she should just suck it up. This is your new vagina, just deal. So she found someone else who was very understanding, had it done and is very glad she did.

[herwitsend]

I had a first degree episiotomy that was stitched. I still had a skin tag that had to be cauterized. I was able to have sex shortly after that, but it was still really painful until dd was almost a year. It would randomly throb and cause pain, too.

It is so good to finally feel normal again! I hope you find someone to repair your perineum. You can consult a plastic surgeon. That would be my suggestion. It is probably something they can do in the office under local anesthesia. Do it soon! Don't live with this any longer than you must!

[tinyshoes]

just wanted to chime in with this observation--HTH

After watching a "how to repair perineums" video for physicians that I checked out of the bio-med library at the U of Minnesota, I came to a startling realization:

in order to stitch flesh, a suturing needle must inflict MORE trauma, as the needle passes through the skin, creating a small wound with each insertion

For some perineal tears that involve layers of tissue and are extensive, suturing is worth the added trauma of each and every needle poke. However, there are times when a suture could help...or could add more trauma to the area.

[meowee]

I was not stitched properly after my homebirth either (in fact the MW said exactly what yours said, that everything was lined up and would heal fine). I am still really angry about it. I ended up tearing in the same place during my next birth and was stitched properly (had a different ME that time). I healed well after that and am back to normal now. Otherwise I might have been forced to consider vaginal reconstruction surgery.

I'm sorry that this happened to you, it makes me even angrier to hear another story similar to mine.

[nashvillemidwife]

Originally Posted by Bibicaffe

Every woman should insist on stitches... And if you have faith in your care provider, which we of course always should... Then for heaven's sake either let them stitch you or insist that they stitch you.

I respectfully disagree. If the edges come together and does not bleed sutures are rarely necessary. Just one little stitch means at least 6 needle punctures into the tissue and infiltrating the tissue with a foreign substance which can cause more trauma in itself than the tear, not to mention the risk of allergic reaction to lidocaine. And despite our best attempts at sterile technique, you're talking about sticking little pieces of metal into your raw vagina with the potential for infection with each puncture.

I would think that having faith in your provider means not having to insist they go against their experience and expertise - isn't that what you hired them for? I've stitched three times in 7 years (used glue a couple times too), and every tear has healed nicely.

Sutures aren't a guarantee that a tear will heal nicely either. In fact, if the edges aren't well approximated the sutures can force them to heal up incorrectly, leaving skin tags or even creating abscesses. Knots that persist after the tear are scars, which is a caused by healing, regardless of whether or not it was aided by sutures.

I'm sorry this happened to you and I'm sorry that your midwife was so flippant about it - that was inappropriate. And I'm not saying that her decision not to stitch was a good one, but in general I don't agree with the sentiment here that every tear needs to be stitched.