perineal tears and healing questions/ issues - Mothering Forums

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#1 of 20 Old 02-05-2007, 04:06 PM - Thread Starter
 
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i birthed at home w a mw. due to the rapid decent and birth of my ds3, my perinum tore as did my labia minor on the left side, it also feels like the tear when deep into the left side of my anal area. my mw stitched me up some, but not completely. She stitched the perineal layers within the 2/3rd degree tear, but not the top layer. She tried to stitch the labia, but it just didn't do right.

I'm 13 days PP and really not happy. My pernium is a gapping hole to my vagina. My labia minor is also just a gapping wound.

at 8 days PP my mw came and checked me and stated that it was healing well. What is well?
How long does it take for skin to adhere back together?

I'm seriously contemplating calling a trusted gyn and asking if he can re-stitch me. I honestly don't know if that is something someone can do for me now or if I'll have to wait for the wounds to heal and then go in for some sort of reconstruction (at which point insurance likely does not pay for plastic surgery).

Bottom line I don't want my perinum to be open for the rest of my life. I'm likely done having children. I don't need to be loose for any reason. My labia will not heal back to "normal", that I can live with. I simply can not live with my perinum being open to my anal opening.
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#2 of 20 Old 02-05-2007, 04:46 PM
 
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I think you should definitely call the gyn. It might be healing better than you think, but I think you would feel better to get the second opinion. And if it isn't healing well, now would be the time to address it. Many midwives don't do much stitching because in general, vulval tissues are very good at healing themselves. But if you're worried about it, you should get it checked out. Good luck!
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#3 of 20 Old 02-05-2007, 07:57 PM - Thread Starter
 
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I put a phone call in to the trusted gyn's office. He had gone home for the day (which is one neighborhood over from me). Anyway... It must be his nurse or maybe a PA who answered, she asked if it was something she could see me for, not likely. I told her in brief what was going on and that I'd like a second opinion or at least to know what my next steps should be. The doc is in surgery tomorrow AM, so she said I'd hear back from her or doc tomorrow afternoon. I hope he calls me back, we attend church together.

It still took a lot to call him b/c he suggested my c/s w ds2 and now I've had 2 hbs. He had all the right words to convience me in 2001 that c/s was my best option, such as vaginal integrity: ... Now I want him to evaluate my totally gapping wounds from a super fast vaginal birth! I just have to believe that God will guide his response.

I'm not in "pain" or major discomfort, for this I am greatful. I have read so many worse stories today. I almost feel like I'm being petty. BUT it is my body and if I'm not happy, then I need to find a solution.
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#4 of 20 Old 02-05-2007, 11:06 PM
 
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Electra, I can relate so I hope my words comfort you. I had a VBAC with my 2nd baby and had a 2nd degree tear that was stitched up. A couple weeks pp, I checked it out and it looked "open" to me (kind of resembled a crater). I went to see my OB/GYN and they decided to keep an eye on it for the time being. But at my 6 wk pp check up, it hadn't healed properly and that was a problem cuz it could get infected with fecal matter.

I was really worried about it and cried cuz I just wanted to be healed by then and didn't want any more stitches in my perineum. I told my doc my fears and she was so sweet and comforting to me. I wish I could remember exactly what they did, I think they "shaved" off the scar tissue and used silver nitrate(?). They numbed the area ahead of time and it didn't hurt anywhere near as much as I had feared. I think it took 1.5 - 2 weeks to heal and it healed beautifully. I hope that makes you feel better, it was worth it IMO
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#5 of 20 Old 02-06-2007, 02:42 PM
 
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Honestly, if he's talked to you about "vaginal integrity" while pushing a c/s I don't think he would be an unbiased source for a second opinion.

Ask around and see if anyone can recommend a ob/gyn you can go to. It is worth the second opinion, I just would find a different one.
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#6 of 20 Old 02-06-2007, 03:06 PM
 
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Quote:
Originally Posted by Electra375 View Post
It still took a lot to call him b/c he suggested my c/s w ds2 and now I've had 2 hbs. He had all the right words to convience me in 2001 that c/s was my best option, such as vaginal integrity: ... Now I want him to evaluate my totally gapping wounds from a super fast vaginal birth! I just have to believe that God will guide his response.
Well, that could actually be a good thing - he is a surgeon, he's good at surgery, and surgery may well be what you need or want in this case. Sort of like, if you really need a cesarean, going to the totally non-natural birth OB who does 5 a day might actually be better, as much as you'd avoid him if you didn't want a cesarean.

On the other hand, I have often heard that it's hard to assess your own healing so soon after birth, and that things that look and feel really awful often heal up just fine. But it sounds like you want someone experienced to take a look at it - I hope you get a good answer and continue to recover.
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#7 of 20 Old 02-06-2007, 03:09 PM
 
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My hba2c resulted in a 'lovely' second degree tear, labial tears and skid marks (as my MW called them).. my DS had a nuchal hand..oiy

It hurt to pee for 2 weeks.. hurt to the point of me crying.. I popped my stitches too..
I was horrified at how things looked 'down there' and convinced I would never heal...I thought i might need cauterization...
Here is what my MW said to do

Sit with my knees together at all times..
Keep my legs together when getting into and out of bed, as much as possible
Apply honey to my pad to help in healing
Apply aloe from an aloe plant to the tears
Apply Miracle salve to the tears
Use an herbal sitz bath


It really worked and I am healing well.

I hope you feel better soon!
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#8 of 20 Old 02-06-2007, 03:28 PM
 
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I'm sorry you're dealing with this, and hope you can find the right solution, whether it's surgery/new stitches/natural healing as suggested by the PP, etc.

One thing I would also concur with is getting an opinion from a different OB. You didn't trust this OB's judgment previously when he advised a C-section. Why wasn't God speaking through him then? What would make you think he would give you the best advice now?

I bet if you looked through the Finding Your Tribe area here, you could get a great recommendation for an OB in your area.

Hope you heal quickly, mama!
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#9 of 20 Old 02-06-2007, 03:33 PM
 
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It hurt to pee for 2 weeks.. hurt to the point of me crying.. I popped my stitches too..I was horrified at how things looked 'down there' and convinced I would never heal.
Me too. I remember thinking I had an infection and would be deformed forever etc. Somehow over time things have come together down there. I still have some soreness and haven't dtd yet but I feel like it really just needed time. If you are very concerned about the stitching job go in to see an OB.

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#10 of 20 Old 02-06-2007, 04:29 PM - Thread Starter
 
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the GYN WON'T SEE ME, nurse on phone said it was a malpractice issue, it might be, but I think it is b/c I said I birthed at home with a mw. Yesterday on the phone it was he could not see me until 6wks b/c I had to be released from the OB first. What kind of crap is that? Don't I have a right to see whomever I want to see? Apparently NOT.
[and while he recommended a c/s w/ #2, I had that c/s and it was a blessing b/c it cleaned up the mess from the botched c/s w/#1 which is the only reason hb was a safe option for me last time.]
But anyway, I just see this as he isn't the one I need to see now.
As for OBs in this town -- there were 3 practices, 1 split 3 ways and they were the one who nearly killed me and my ds1 in 98, the next 'terminated' my care during my 3rd pregnancy weeks before the sch 3rd c/s which resulted in my first hb and the last practice only takes new patients on tues mornings and I just cringe at having to 'comply' with garbage just for an opinion. Did I mention I loath the OB profession in general...
So that leaves driving to another town. I use a CNM some 45 miles away for well woman care, but I don't think she is the right person to see for this.
Maybe I'm not supposed to waste my time seeing anyone about this right now. There is a practice with high recommendations in a town 70miles away,but they were not taking new patients when I was pregnant and I am on the list to call when an opening occurs.
I'm on the verge of tears
And if I contact say another lay mw then it might get back to my mw and be offensive... and several of the other lay mws are in my tribe...
I feel really stuck. I'm not able to see a local GYN, I'm not able to see a local OB. I'm not able to get a second opinion from a lay mw. And I don't think the CNM would be any better... Who does one go to for female repair? At this point, I do not think anything can be done now, I fear it will be surgery later. I can't say I wish I had gone to the hospital for repair as that would be the same OBs who I can't see b/c of the above reasons. I can say I wish I had been more educated about tears to say stitch me up all the way.
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#11 of 20 Old 02-06-2007, 05:41 PM - Thread Starter
 
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for kicks i called an ob locally
My mom said to say i just moved here, so i went with that
I was told to go to the Emergancy Room!

So, am I to assume that no ob will touch you PP if you were not their patient?

This is ridiculous. b/c I'm not about to go to the ER.
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#12 of 20 Old 02-06-2007, 05:54 PM
 
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It's not uncommon I'm afraid...I didn't have an OB with my first delivery, but I wound up with a c/s anyway. I'd never met the surgeon who did the operation, and saw him only twice after the c/s. Once to check the c/s and the second time to remove the staples. The hospital told me to "remove the tape in a few days and get the scar checked", but my own care provider has no surgical wound care experience so she told me she couldn't do the "check". And when I called the office for the OB who did the surgery I was told that since I wasn't his patient he couldn't check me, even though he is the one who did the surgery!

I live in a pretty small town and all the care providers know each other so maybe they just don't want to step on any toes? But it left me in a really tough spot trying to figure out, on my own, if everything was healing "right"!

Perhaps you could call the midwife you used and let her know that, given your experiences with birth injuries in the past, you really feel strongly about having a second person take a look? I know she is happy with how it is healing, but as you said...it's your body, and your concerns, and hopefully she will understand that. She should be able to send you to someone (so you wouldn't be a new patient, you'd be referred) to get it checked, or perhaps call a second midwife (her backup person perhaps?) to check things out. It's not perfect, but it would get you a second opinion!

Good luck mama....I hope you heal well!

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#13 of 20 Old 02-06-2007, 06:03 PM
 
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hi- i had an awful tear (forward) with my 1st and an awful stitch job which never healed properly. 6 wks post partum, I had recontructive surgery to reopen the vaginal opening which my doctor for some reason sewed 3/4s shut. I now, not from the new surgery, but from the initial tearing itself, have terrible and constant pain. My new OB says it's vulvadynia. Anyway- I would just do whatever it takes to get stiched up properly now. I wouldn't wait. Just do whatever it takes. Cause what I'm dealing with now SUCKS- and it's a result of bad stitching.
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#14 of 20 Old 02-06-2007, 06:35 PM
 
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OK, what about calling the CNM, telling her your story, and asking her for an OB referral? Usually all it will take to get an appt is a call from another care provider. They may not be accepting new patients, but they are often willing to accept new referrals. (And of course, they wouldn't tell you this on the phone.)

While you're sorting this out, I would use some of the methods outlined above to encourage healing on your own.
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#15 of 20 Old 02-06-2007, 06:40 PM - Thread Starter
 
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I cried and had my pity party and then got on the phone again before 5pm would hit. I had lost it on the phone with the last receptionist, crying lost it. I went to our insurance web page and just picked the next on down the list.
I called someone I hadn't heard of in town before with his degree from Australia (land of hbs) in 1972. He is just listed as GYN. Now why couldn't my former GYN see me? This guy can.
So tomorrow at 11am I will see what's going on with my perineal and labia tears.
My mw was going to be stopping by tomorrow. I should e-mail her to say something, but what?
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#16 of 20 Old 02-06-2007, 06:43 PM
 
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I'm glad you found someone.

I would just tell her you were really concerned about your perineum and decided to get a second opinion in case you needed surgical repair.
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#17 of 20 Old 02-06-2007, 11:15 PM
 
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I hope you can get in to someone soon. My labia minora tore all the way through and by the time I could get to my OB (2 days) it had already started to heal incorrectly. I had reconstructive surgery 14 months later. I don't say that to discourage you, just to let you know that that is a possibility. *hug* I'll be thinkinig of you.
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#18 of 20 Old 02-07-2007, 09:53 PM - Thread Starter
 
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X post with So beyond disgusted...

I did get an appt w a GYN in town, I lied about my situation to do so . I went this morning. This guy didn't even take a standard history! And I only gave information regarding the current issue. I did like the man and he was compassionate. I will be going back at 2mo PP for another evaluation and was told since my situation was unique that I could call anytime and they would fit me in, if I needed anything -- NICE, super NICE. I've loathed doctors for so long, it is nice to have a few that I actually don't.
Anyway, there is not anything to be done at this point but to wait for the internal rectal area swelling to go down (which I didn't know was still going on), skin to continue to make contections, and blood flow to be reduced back to normal in the area. I gathered that currently the blood vessels are working over time to repair the damaged tissues and this would create problems in doing surgery now.
Once the healing that is going to happen, happens, which his time frame was 2 months, then we can talk reconstruction Plastic Surgery. I did ask who does that kind of work and he said he could do it at the out patient surgery center. We didn't talk details at this time which is fine b/c I realized that I have more healing to do yet and the final result of my healing will determine what needs to be done, if anything. He stated that since my bladder and bowel are functioning, I'm rather lucky (and he is right, I've read many mamas here who have bigger problems) and that surgery would be more likely an asthetic thing for me and possibly slightly on the function side with the perineum tissues.
He also explained that I might be content with the way things heal and decide that further surgery is not for me. He said it would depend on my dh and I and how we felt with regards to sex etc. He came out with me to the waiting room to see my "shooting bullet" baby, my mother was in the waiting area with my ds3.
I sort of felt after much reading that my situation would likely only be resolved with surgery later. My regret is that I didn't know that my mw should have stitched me to the surface layers. I would have asked her too and she would have, had I know to ask. I know other women can heal those layers, but for some reason my body isn't. As a mother of now 4 small children to care for, my mw should have realized that down time more than a week would be a huge pushing it.
The GYN stated that I should do no heavy lifting or moving for 2 months b/c that would strain the perineum area. That means no getting into the gym, no sit ups, literally still "legs together and resting" for 2 whole months! I'm blown away by the fact pushing my 3 youngest in a shopping cart is not 'recommended' for the next 6 weeks. I can't lift my other children into the cart or seat either or van or carseat (they are 4 and 2 and the 2 yr old can't get in her seat by herself). Again, I feel my mw did do me a diservice. I would have also liked a bit more hands on which might have avoided the explosive birth that resulted in this trauma to begin with.
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#19 of 20 Old 02-08-2007, 01:53 AM
 
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If you have the resources, you might try working with an ND or a homeopath to help repair the damage from the inside out instead of the outside in.
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#20 of 20 Old 02-08-2007, 02:15 PM - Thread Starter
 
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So much for not lifting and moving heavy objects... This morning I had to remove my 4 yr old from his sister, who is 2. I didn't even think, I just did and then I felt the strain... And was mad at myself. My 4 yr old is my "challenging" child, meaning he is nice one minute and throwing or hurting someone the next. How am I to keep him and the others safe if I can not physically move him for 6 more weeks?
The more I realize what not stitching me through to the top layers means for my life, the more angry I get with my mw. I don't even care that she didn't call yesterday to say she wasn't coming, she said she was coming last week to check on me this week.
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