VAGINAL TEARS at birth are AVOIDABLE

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In the last issue, we explored how vaginal tears (perineal lacerations) occur and when to seek specialist treatment. In this issue, we answer the question whether you can avoid tearing altogether and also give you tips to a speedy recovery when you get a tear.

For years, many within the medical fraternity believed that a routine episiotomy (the surgical incision of the tissue below the vaginal opening during childbirth), taken as a cautionary move, could reduce the risk of tearing.

However, research has shown the premise could not be further from the truth. Obstetric bodies worldwide have called for the reduction of routine episiotomies (not to be confused with episiotomies for specific emergency situations such as foetal distress) and instead emphasised better handling of patients and procedures to mitigate or avoid tears altogether.

Unfortunately, for many women especially on this side of the hemisphere, this information is unknown. There are many known ways of helping a woman avoid vaginal tearing during birth. Below are some of them:

Perineal massage

According to research, massaging the perineum for 10 minutes can reduce the chances of a tear by 10 per cent and an episiotomy by 16 per cent especially in first time births, as it increases the elasticity of the perineum.

Avoiding the urinary tract and using clean hands and a lubricant such as petroleum jelly, place your thumb inside the vagina and press downwards and sideways towards the rectum and hold for one to two minutes until you get a tingling sensation. Then slowly, massage the lower half of the vagina. Once a day should be enough.

Expectant mothers can start this manoeuvre at 33 weeks and continue all the way to childbirth. Avoid the massage if you have active herpes lesions to avoid infection to other areas.

Birthing position

Research has shown that standing, squatting or kneeling positions during childbirth has far less tearing consequences as opposed to the more traditional lying down on the back position.

Discuss with your caregiver about the appropriate position for you. Being on free government maternal healthcare does not mean your right to know is stripped away. Ask about your options and air your concerns to avoid any future regrets.

Warm compresses

This is recommended during the second stage of labour where your caregiver places a warm cloth on the perineum to soften it up and make it more flexible.

Support

Having the right support system at your side be it a family member, spouse or caregiver has been shown to help expectant mothers have a stress-free delivery.

As a value add, enroll with your partner for childbirth classes to learn a few tricks such as breathing and relaxation techniques and to help you become aware of what your body will undergo during delivery.

Healing

Common tears do not require hospitilisation once the doctor puts in the sutures. With antibiotics, some home based tips and proper hygiene, the wound should heal easily and completely anywhere between two weeks to six months. Here are some tips to speed up the process with minimal pain.

Do…

Aerate:Going panty-free for up to 10 minutes a day will keep infections at bay.

Drink:Water goes a long way to ensure you do not suffer urine burns when peeing.

Eat:Constipation coupled with stitches on your nether regions inspires only one word: Ouch! Bulk up on high fibre foods to ease bowel movements.

Sit bath:Women from all generations can attest to the healing, relieving and comforting powers of a saline sit bath. A 10 – 20 minute sit down once to three times a day is enough. If you cannot be bothered to sit, warm compresses on the area are a great alternative.

Dry: Always dab a towel on the area after a shower or tissue after passing urine. Be sure to use front to back strokes.

Swallow:In such trying times, painkillers trump diamonds as a girl’s best friend. Just ensure that they are breastfeeding friendly.

Consult:In case complications occur, for instance if the abdomen or vaginal area becomes painful, bloody or smelly, then its time for a check-up. The same applies if you experience high temperature or cannot control your bowel movements.

Don’t…

Wear tight fitting clothes as it reduces aeration.

Blow-dry the area as this excessively dries out the area, inhibiting healing.

Insert a tampon, exercise heavily or resume sex unless your doctor gives a go-ahead.

Published in June 2015

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