I found this article from BabyCenter.com to be helpful but also disturbing- it stated that 1 out of 10 women need and episiotomy - in my experience not even 1 out of over 200 women need an episiotomy. (One birth was close- as baby’s heart began to decelerate and moms pelvic floor muscles were extremely strong-like olympian strong.) Overall, patience and nutrition helps moms to not even tear during birth- it’s even rare that stitches/sutures are needed in my out of hospital birth practice.
Helpful parts of the post are included below.
How long will my stitches take to heal?
Most tears or episiotomies heal well. Bruising usually gets better within a few days. Your stitches should dissolve after two weeks, and you should heal within three weeks to four weeks of your baby's birth. After two months you should be pain-free.
However, healing time and recovery from pain does depend on the severity of the tear. Even if you had a very severe tear, you're unlikely to have problems a year after your baby's birth.
How can I ease perineal pain from stitches and bruising?
Take it easy. Being up and about is good for your circulation, but if you develop a heavy, dragging feeling in your perineum, take the weight off your feet for an hour or so.
While you're waiting for your stitches to heal, try these tips:
Keep your wound cool
This may help to reduce the swelling in the early days. Put a cold gel pad or frozen pack of peas on your perineum. Try lying on your side with the pack between your legs. Wrap the pad or pack in a clean flannel to protect your skin, and don't leave it on for longer than half an hour. Wait an hour before re-applying it.
Use warm water when you wee
Pour warm water over the area while you wee. Use a clean jug, or a thoroughly washed plastic squeezy bottle. The warm water will dilute your wee, reduce the sting, and keep your perineal area clean. Gently dab your stitches dry with toilet paper, from front to back.
Sit more comfortably
If it's uncomfortable to sit, use a doughnut-shaped cushion or a Valley cushion. Ask your midwife for a Valley cushion, or hire one from the National Childbirth Trust.
Have a warm bath
As things ease, you can have a warm bath, perhaps adding a few drops of lavender oil or tea tree oil to the water.
There's little evidence that warm baths or essential oils help with healing, but they can be soothing. Sit in the water for about 20 minutes, twice a day. Pat your stitches dry with a clean, soft towel.
IBProfin may be helpful during the first few days as it may help reduce swelling and pain.
There's no evidence that witch hazel helps with irritation or swelling, but some mums swear by it.
Make a witch hazel compress by sprinkling witch hazel onto a maternity pad and putting it in the freezer. When you take it out, give it a minute, then press it onto your perineum to get relief. Alternatively, dab witch hazel straight onto your stitches with a cotton pad. Make sure you wash your hands thoroughly, before and after.
How can I help stitches in my perineum to heal?
Making sure your stitches are clean will help them to heal as well as reduce the risk of infection. Try these self-care tips:
Have a shower or bath at least once a dayChange your maternity pad or sanitary pad regularly, and wash your hands before and after you do it.Keep an eye on your wound. You can check your perineum with a hand mirror to see how well it's healing.Keep doing your pelvic floor exercises, as this will help with healing, improve circulation to the area, and prevent leaking from your bowel or bladder.Expose your stitches to the air. Take off your pants and lie down for 10 minutes, twice a day. Put a clean towel underneath you to protect your bed linen or sofa.Wear loose clothes so the air can circulate round your wound. Drink plenty of water every day, and eat fibre-rich foods, such as wholemeal bread, brown rice and fruit and vegetables, to help prevent constipation.
If you had a severe tear, take a course of natural antibiotics to guard against infection.
Prunes, plenty of fluids and stool softeners May make it easier for you to poo without straining your stitches.