Guess I don't really need a perineum (long) - Page 2 - Mothering Forums

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Old 06-03-2005, 01:08 AM
 
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If you get low on iron occasionally, maybe floradix is a good idea for general post-partum care, but I don't think it's the answer on this.

I'll "talk" outloud so you can see where I'm going - this is my understanding:
During your daughter's birth, your perineum experienced some extreme stress, breaking down the functional connective tissue along an old scar line. Several days after the birth, the skin also split along the scar, leaving the tissues gaping apart.
In addition, some of your skin has broken down, leaving only a thin line of mucosa between your vagina and rectum in at least one area.

The area was stitched over again, but is now apart again. The muscles of the perineal area are able to bring the edges together with your exertion.

Since the scar dehesized with this birth, I hypothesize that it did not heal properly the first time. It is not uncommon for a subsequent birth to "repair" the perineum, for a woman to be cut with her first birth, heal but be uncomfortable, and have the scar stretch and revise after her second birth, releaving the discomfort and lack of function. It is uncommon to see a complete failure of the scar with healthy tissues in a well nourished woman. So I think: is she healthy? is she well nourished? does she have undiagnosed STD or infection causing tissue problems? Since you did have prenatal care and I "know" about your nutritional status from your posts, these don't seem likely, but you tell me...

Next thought: something is keeping your body from laying down the foundation strips of scar that lead to full repair. You didn't lay down the collegen and fibrous tissue after the first repair, leading to the failure of the scar with this birth. You didn't lay them down again, leading to the second failure after the stitches started to wash away. Having lots of scar tissue to the touch doesn't mean it's orderly and working, even. Think of a pile of yarn compared to a knitted blanket - one holds tension and one would not. The underlying network to heal a scar looks a lot like a badly crocheted afghan blanket with lumps and bumps and a basic network. Over time, this strong but disordered net revises to be a thinner, more uniform (more experienced crocheter) net.
So next line - how is your blood, specifically platelets and iron? Do you have have the raw materials to repair tissue? Iron is important for that, but not the #1 item. It would be something that is NOT just now because it affected your first birth, too. If you had a global platelet problem, your midwife would have seen it during prenatals for one, and my questions would have rung a bell like "oh, yeah, my bloodwork is always interesting".
So, next thought.
How do you heal in general? Do you have lots of scars? How about past surgeries if any? Do you have thin pale skin? Are you red headed? Sprains, breaks, etc?
And final thought - stop with the vitamin E and anti-scaring, good healing stuff perhaps - a lot of that is designed to make thin efficient scars and supple, elastic skin. It might be the wrong direction to go for right now.

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Old 06-03-2005, 01:27 AM
 
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You've already gotten great advice, so I just have this to give you -

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Old 06-03-2005, 04:14 AM - Thread Starter
 
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Apricot: Thanks for all that information. I'm not sure where to go from here. I didn't start Vitamin E or anything like that until last week. I've only taken Vitamin E orally for the past 3 days and I've been taking Grapefruitseed Extract in pill form in case there was some sort of infection that was breaking down the tissue. I also felt yeasty so thought the GSE would cover both issues. My doc prescribed antibiotics but he's already had me go through two rounds and I hate how they make me feel yeasty so I didn't take them. I didn't tell him I wasn't taking them and feel a bit bad about it. I don't know how I'll bring that up to him. I should have discussed it first but Amelie was crying and I was in a hurry to get home. I was under the impression that he was prescribing them as a preventative.
My scar held up for the most part after birth #2 but it fell apart after birth #3.
I have tons of scars. I think I'm accident prone. I am missing two finger tips from an accident when I was 4 and have had 3 reconstructive surgeries on them. The last one was 14 years ago and I healed quickly. I also busted my face pretty bad in a car accident 15 years ago. I healed quickly from that and had reconstructive surgery the following year which healed nicely. Two years after that I ran into a door and split my eyebrow. That also healed quickly. But this is old news. I haven't had any major issues except for the tear in 2001 at my first child's birth. According to the surgeon, I healed well except for an extra bit of skin that he removed 2 weeks after the original surgery. The scar split a tiny bit after birth #2 but the stitch the midwife put in fell out and it healed together on its own.
I sliced my finger open with a knife during this last pregnancy and it healed quickly. I don't know of any strange bloodwork results except for low iron. All STD bloodwork came back negative.
My life is hectic lately and I could be deficient in something. I didn't really take prenatals this past pregnancy like I should have. They made me ill in the beginning and then I kept forgetting later on in the pregnancy. I have never taken one prenatal pill, but took vitamins separately to get what I assumed I needed. My midwife was aware of the vitamins I was taking even though I didn't take them on a daily basis. I do eat a vegetarian, mostly organic and whole grain diet and take a daily flax seed oil supplement.

I was thinking about this earlier tonight and wondering if I could do an experiment. I have a slightly herniated belly button. It popped out the very last day of my first pregnancy and hasn't gone back in. It doesn't hurt, but my OB/GYN and midwives have both said the only way to get it back in is to have it surgically put back. Would having that procedure done while I have my perineum repaired give some answers on the state of my body's ability to knit tissue together? What I'm asking is will I know more about my perineum if my belly button heals fine but my perineum doesn't?

And I have questions about perineums for anyone who wants to answer. Can I go through life with a 1/8th inch long perineum? Will it affect my ability to have more children? I don't think I want more at this point, I'm just curious.

Thanks for the hug, Itlbokay Nice user name
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Old 06-03-2005, 02:58 PM
 
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Kava, I "see" a lot of self-blame in your last post, about vitamins, antibiotics, vitamin E and GSE, etc. In response, I want to clear up a few things about my post. When I suggested infected tissues, I meant a raging case of bacterial vaginosis or long-standing clamydia, not yeast or a small infection after stitching. Poor nutritional status was meant to imply very poor nutrtion - anorexia or complications of crone's disease, not whether you take prenatals.

I think of this like trying to get something off the top shelf. There is nothing to be done about the fact that someone is 5'2" tall - there is only to supply a chair and try not to fall off. Suggesting that there is any blame for the condition is not helpful unless the person has recently taken a hacksaw to her ankles. The chance of you having caused this is about as likely as someone taking a hacksaw to your ankles recently.

The only complication I can think of with a very short perineum is your physical discomfort and a higher risk of cross-infection from the bowels to the vagina. If you ever wanted a bidet - this is the perfect excuse to get one.

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Old 06-03-2005, 03:08 PM - Thread Starter
 
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I have a bidet! Now I just have to convince Dimitrius to pull it out of storage and install it. It's a toilet top one. It was lovely after births 1 and 2. Everyone should have one!
http://www.washlet.com/chloe.asp
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Old 06-03-2005, 03:19 PM
 
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I'm jealous, you know. I want a bidet.

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Old 06-08-2005, 06:11 PM
 
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Quote:
Originally Posted by Apricot
Since the scar dehesized with this birth, I hypothesize that it did not heal properly the first time. It is not uncommon for a subsequent birth to "repair" the perineum, for a woman to be cut with her first birth, heal but be uncomfortable, and have the scar stretch and revise after her second birth, releaving the discomfort and lack of function.
Apricot, that is so interesting, and indeed was my own personal experience. I had a too-tight episiotomy repair, and then my homebirth w/ #2 resulted in a small tear....and that tear UNDID the too-tight repair, and rendered my perineum happy again, just like it was before my OB's sewing project. I just wanted to chime in, 'cause perineal happiness is a topic of great importance to me!
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Old 06-09-2005, 03:27 PM
 
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That's awesome that it's back to goodness and happiness again.

"OB's sewing project" - snork!

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Old 06-09-2005, 03:37 PM
 
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I haven't read through the whole thread, but I second (or third) the plastic surgeon. At this point you will probably have to have reconstructive surgery.

ETA:

Just read the whole thing. Glad it's ok!
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