Question about a laceration - Mothering Forums

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#1 of 9 Old 03-09-2008, 12:08 AM - Thread Starter
 
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After the birth of my daughter I suffered a laceration. My midwife determined the laceration should not be sutured. She believed the laceration would heal on it own and it would take some time heal. However, after three months postpartum the laceration has still not come together, and its can be painful sometimes. At my 6 weeks postpartum checkup my midwife looked at the laceration and reaffirmed that it would heal.
I then decided to go have a IUD inserted at a local clinic. While at the clinic the clinician took a look at the laceration and stated that laceration was in fact healed and that it has healed in two separate segments. She also said in order for it be one again they would have to make a tiny incision and resuture the area.
After I had the conversation the clinician I contacted my midwife and let her know what the clinician told me. She again stated that it would heal and that it was a bad idea So now I have a laceration and I have no confidence in it ability to heal on it own and I am clueless about what to do next.
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#2 of 9 Old 03-09-2008, 12:32 AM
 
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Is it a vaginal laceration, labial, clitoral?
Many lacerations do heal on their own - and sometimes using sutures can be traumatic too. Labial lacerations are sometimes hard to suture back together, and will heal in two segments. This isn't a problem, but can be upsetting because of the way it looks.
Carla
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#3 of 9 Old 03-09-2008, 12:43 AM - Thread Starter
 
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#4 of 9 Old 03-09-2008, 12:50 AM - Thread Starter
 
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Originally Posted by mendomidwife View Post
Is it a vaginal laceration, labial, clitoral?
Many lacerations do heal on their own - and sometimes using sutures can be traumatic too. Labial lacerations are sometimes hard to suture back together, and will heal in two segments. This isn't a problem, but can be upsetting because of the way it looks.
Carla
It is labial laceration and is very upsetting because of the way it looks, and it actually hurts sometimes... Im confused about what to do..
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#5 of 9 Old 03-09-2008, 01:38 AM
 
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I had a perineal laceration that healed open and I hate the way it looks, but it doesn't cause me any pain. I tried to learn to live with it, but 2 years after I gave birth I had a midwife try to fix it. She had to cut me back open and suture it together. It was very sore and painful healing for about a week (at once point I feared it was infected, but it wasn't) and then I realized that the sutures had popped out and it had gone right back to the way it had been for 2 years. All that for nothing. At this point, I'm willing to be satisfied that I don't have any pain/discomfort and I'm sexually functional. I try to be reasonable in that no one is looking critically at that area of my body (except for me, which is ridiculous anyway).

I would give it some time and see if the pain is resolved. I think once it is totally "healed" (it won't heal together, but the tissue will heal a new way) you probably won't have pain. If you do, and you decide to have it repaired, find somebody very experienced who is very confident that the repair will work. I realized after the fact that my decision to have my cosmetic tear fixed was dumb; I could have lost sensation or function, gotten an infection, had other complications.

"If you only knew how many things I want to say and don't, you'd give me some credit."
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#6 of 9 Old 03-09-2008, 02:42 PM
 
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My understanding is that it's really hard to heal from labial stitches. I know though, that surgeons can fix labia for women who have either had a labial tear or who simply don't like the shape of their labia... but it may be a rather extensive surgery like rectocele/cystocele repair, and may be considered plastic surgery. ???

I think I'd be more inclined to believe the midwife who has seen lacerations than a clinician who inserts IUDs, but maybe that clinician has childbirth experience, who knows. Some practitioners suture every tiny thing even if it's just one stitch, while others don't because healing from stitches can be quite painful and something only needing a stitch or two isn't a very big laceration.

So, all that to say... you may be more likely to be told you need repair if you go to an OBGYN because they tend towards repair of any little laceration IME.
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#7 of 9 Old 03-09-2008, 04:06 PM
 
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If you're still having pain, getting it repaired seems like a good idea.

Another thing-while taking responsibility for one's health is a cornerstone of midwifery care, and the philosophy of most people here on this board, it can be a two edged sword-I hear lots of language that indicate self blame. Your body can heal itself just fine, but it needed/needs some help.

Some women need c sections, some babies need resuscitation, and some tears need to be stitched.
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#8 of 9 Old 03-09-2008, 06:56 PM
 
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I would give it some time - but if it was a simple laceration it would not be extremely tender at this point. There could have been some underlying muscle involvement that needs to be repaired. I agree that this would be done by an OB. If you decide to go that route, know that the repair would have to be done under general anesthesia. Ask as many questions as you can about exactly what they think they would be repairing. It might help to ask a second opinion. You want to find someone who says they are skilled in this area and who also has a good knowledge of cosmetic repair techniques.
When the labia tear they are thin and hard to suture together. I have found that holding the two edges together flat between the thumb and forefinger and then whip stitching them together works almost every time. The torn edges need to be sutured together in order to heal back together.
I also agree with the OP - don't blame yourself or your body for not healing.
You might try some arnica oil and massage around the area that is tender.
A good exam would help - you could also have a hematoma (bleeding) underneath the area - this can be painful for some time before it resolves.
Good luck....
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#9 of 9 Old 03-11-2008, 10:54 PM - Thread Starter
 
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Originally Posted by jengacnm View Post
If you're still having pain, getting it repaired seems like a good idea.

Another thing-while taking responsibility for one's health is a cornerstone of midwifery care, and the philosophy of most people here on this board, it can be a two edged sword-I hear lots of language that indicate self blame. Your body can heal itself just fine, but it needed/needs some help.

Some women need c sections, some babies need resuscitation, and some tears need to be stitched.
Thank you all for your input...

I can see how I could be blaming myself. I now realize it more than the laceration issue. It think it has to do more with my expectation of my birthing process. I am questioning if I made the right decision to have a natural birth at a birthing center under a certain CNMs care. Overall, I was pleased with my prenatal care. However, I feel let down with my postnatal care, and I believe this is where the laceration concerns come in. I think I would be more inclined to accept this minor laceration if I was given all of the information on all possible implications. I just feel I have been brushed off and slighted in some way. I am sure I will feel better once I process my whole birthing experience and accept it for what it is and was....
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