How long does it take for external stitches to heal after childbirth? How long do internal sutures dissolve and how do they heal after childbirth?

Today we will talk about a website for mothers, how to care for stitches after childbirth and how to relieve pain.

When are stitches placed?

Many women undergo surgery followed by suturing during childbirth. Surgical intervention is not uncommon during childbirth; doctors resort to this method of assistance for several reasons:

Premature or rapid birth, when the fetal head takes on heavy loads, an episiotomy is performed - an incision in the perineum to prevent injury to the newborn's head;
Breech presentation during childbirth - to avoid fetal loss, a caesarean section is performed - an incision in the abdominal wall;
The presence of scars on the perineum after previous births - the perineum is not elastic enough;
To eliminate attempts due to health problems of the mother in labor, again, they do a cesarean section;
Prevention of perineal rupture - it is believed that an incised wound heals faster and the seam is more accurate.

Every woman in labor needs to be prepared for possible incisions to facilitate childbirth.

Caring for postpartum stitches

The doctor examines the genital tract after birth and applies internal or external sutures if necessary. The internal sutures practically heal without pain, but the external sutures hurt after childbirth for 1-2 months.

Internal sutures on the cervix and vaginal wall are made with natural self-absorbing suture material and do not cause much discomfort. Caring for internal sutures involves following the rules of personal hygiene and avoiding sexual contact for one to two months.
Sutures are placed on the perineum using various suture materials and in quantities completely dependent on the length of the incision. Sutures on the perineum can be applied with both self-absorbable and non-absorbable materials. The stitches on the perineum hurt a lot in the first days after childbirth, since in addition to the incision itself, the holes in the places where the tissue was punctured hurt. It is necessary to wash the perineum with soap twice a day and rinse with warm water during the day. You need to wash the perineum with seams carefully and thoroughly. Dry with blotting movements from front to back, do not rub under any circumstances. It is better to use a soft, moisture-absorbing cloth. To maintain the dryness of the perineum, it is necessary to frequently change the pads, washing the seams with a weak solution of manganese if the seams hurt after childbirth. For the first two weeks, a woman is not recommended to sit on both buttocks; it is better to try to sit on her side. To avoid constipation, since women usually do not have bowel movements for 1-2 days after giving birth, try not to eat foods with a constipating effect. You can drink a tablespoon of any vegetable oil before meals or use laxative suppositories as recommended by your gynecologist.
Sutures placed on the abdomen after cesarean section require constant care during the first month. In the first week after surgery, the suture is treated daily with an antiseptic solution and the bandage is changed. Cosmetic sutures are applied with self-absorbing materials, which completely dissolve 60-70 days after application. You are allowed to shower every other week, but it is not recommended to use a hard washcloth. Try not to lift more weights than your baby's weight during the first months. If the sutures are very painful after childbirth, in the first days you can administer intramuscular painkillers on the recommendation of a gynecologist.

Why do my stitches hurt after childbirth?

Many women are concerned about this issue within a month after giving birth. We will give several recommendations to alleviate the condition and reduce pain on the website:

Painful sensations make themselves felt constantly if you have to sit down or lift weights often - limit the weight of the objects you lift if possible and try not to sit on both buttocks;
The stitches on the perineum hurt after childbirth if you suffer from constipation. In the first month after childbirth, a woman’s body is reconstructed, lactation requires the consumption of more fluid, and there is not enough fluid for normal bowel movements. A nursing mother should drink more warm milk, green tea, juice or herbal infusion. .
Sometimes the stitches hurt after childbirth during sexual intercourse due to vaginal dryness and natural stress on the perineum. In this case, doctors recommend using a moisturizing gel. Sometimes changing the position to a non-painful one reduces pain.
The sutures hurt and pull after childbirth due to tissue inflammation, then redness and purulent discharge appear. In this case, consult a gynecologist, but under no circumstances self-medicate.
The sutures after childbirth hurt, as postpartum discharge forms a breeding ground for the proliferation of microbes that cause inflammation.

On forums for young mothers, reviews about childbirth contain many questions: why do the stitches hurt after childbirth; how to care for stitches; what to do if the seams come apart? Only a gynecologist can give an answer in each specific case, who will conduct an examination and prescribe treatment if necessary.

During childbirth, situations often arise when it is necessary to apply stitches. Their presence requires increased caution from the young mother and, of course, certain skills in caring for this temporary “risk zone.”

When are stitches needed?

If the birth took place through the natural birth canal, then the sutures are the result of the restoration of the soft tissues of the cervix, vagina, and perineum. Let us recall the reasons that could lead to the need for sutures.

Cervical ruptures most often occur in a situation where the cervix has not yet fully opened, and the woman begins to push. The head puts pressure on the cervix, and the latter ruptures.

An incision in the perineum may appear for the following reasons:
quick birth - in this case, the fetal head experiences significant stress, so doctors make it easier for the baby to pass through the perineum: this is necessary in order to reduce the likelihood of injuries to the baby’s head;
premature birth - dissection of the perineum pursues the same goals as during rapid birth;
the baby is born in a breech position - the tissues of the perineum are cut so that there are no obstacles during the birth of the head;
with anatomical features of the woman’s perineum (the tissues are inelastic or there is a scar from a previous birth), due to which the baby’s head cannot be born normally;
the expectant mother should not push due to severe myopia or for any other reasons;
there are signs of a threat of rupture of the perineum - in this case it is better to make an incision, since the edges of a wound made with scissors heal better than the edges of a wound formed as a result of a rupture.

If the baby was born via cesarean section, then the young mother has a postoperative suture on the anterior abdominal wall.

Various materials are used to apply sutures to the perineum and anterior abdominal wall. The choice of a doctor depends on the indications, available capabilities, techniques adopted in a given medical institution, and other circumstances. Thus, synthetic or natural self-absorbable suture material, non-absorbable suture material or metal staples can be used. The last two types of suture materials are removed on the 4-6th day after birth.

Now that we have remembered why seams may appear, let's talk about how to care for them. If there is a stitch, the young mother must be fully prepared and know how to behave so that the rehabilitation period goes as smoothly as possible and does not leave any unpleasant consequences.

Stitches on the crotch

Healing of small wounds and sutures occurs within 2 weeks - 1 month after birth, deeper injuries take much longer to heal. During the postpartum period, it is necessary to take all precautions so that an infection does not develop at the site of the sutures, which can then enter the birth canal. Proper care of the damaged perineum will reduce pain and speed up wound healing.

To care for sutures on the cervix and vaginal walls, all you need to do is follow the rules of hygiene; no additional care is required. These sutures are always placed with absorbable material, so they are not removed.

In the maternity hospital, the sutures in the perineum are treated by the midwife of the department 1-2 times a day. To do this, she uses brilliant green or a concentrated solution of potassium permanganate.

Sutures on the perineum, as a rule, are also applied with self-absorbing threads. The nodules disappear on the 3-4th day - on the last day of stay in the maternity hospital or in the first days at home. If the suture was made with non-absorbable material, the sutures are also removed on the 3-4th day.

Compliance with the rules of personal hygiene also plays an important role in caring for sutures on the perineum. Every two hours it is necessary to change the pad or diaper, regardless of its filling. You should only use loose cotton underwear or special disposable panties.

It is also necessary to wash yourself every two hours (after each visit to the toilet; you need to go to the toilet at such a frequency that a full bladder does not interfere with the contraction of the uterus).

In the morning and evening, when you take a shower, the perineum should be washed with soap, and during the day you can simply wash it with water. You need to wash the seam on the crotch quite thoroughly - you can simply direct a stream of water at it. After washing, you need to dry the perineum and the area of the seams by blotting the towel from front to back.

If there are stitches on the perineum, the woman is not allowed to sit for 7-14 days (depending on the degree of damage). At the same time, you can sit on the toilet already on the first day after birth. Speaking of the toilet, many women are afraid of severe pain and try to skip bowel movements, as a result, the load on the perineal muscles increases and the pain intensifies.

As a rule, in the first day or two after childbirth, there is no stool due to the fact that the woman was given a cleansing enema before giving birth, and during childbirth the woman in labor does not eat. Stool appears on the 2-3rd day. To avoid constipation after childbirth, avoid eating foods that have a constipating effect. If the problem of constipation is not new to you, drink a tablespoon of vegetable oil before each meal. The stool will be soft and will not affect the healing process of the sutures.

In the vast majority of cases, it is recommended to sit on the 5-7th day after birth - on the buttock opposite the side of the injury. You need to sit on a hard surface. On the 10-14th day you can sit on both buttocks. The presence of seams on the perineum must be taken into account when traveling home from the maternity hospital: it will be convenient for the young mother to lie or half-sit in the back seat of the car. It’s good if the baby sits comfortably in his personal car seat and does not occupy his mother’s hands.

It happens that the scars remaining after the stitches have healed still cause discomfort and pain. They can be treated with heating, but not earlier than two weeks after birth, when the uterus has already contracted. To do this, use “blue”, infrared or quartz lamps. The procedure should be carried out for 5-10 minutes from a distance of at least 50 cm, but if a woman has sensitive white skin, it should be increased to a meter to avoid burns. This procedure can be done independently at home after consulting a doctor or in a physical therapy room.

If a woman feels discomfort at the site of a formed scar, or the scar is rough, then to eliminate these phenomena the doctor may recommend Contractubex ointment - it should be applied 2 times a day for several weeks. With the help of this ointment, it will be possible to reduce the volume of scar tissue formed and reduce discomfort in the scar area.

Sutures after caesarean section

After a caesarean section, the sutures are monitored especially carefully. For 5-7 days after the operation (before removing the sutures or staples), the procedural nurse of the postpartum department daily treats the postoperative suture with antiseptic solutions (for example, brilliant green) and changes the bandage.

On the 5-7th day, the sutures and bandage are removed. If the wound was sutured with absorbable suture material (such material is used when applying a so-called cosmetic suture), then the wound is treated in the same way, but the sutures are removed (such threads are completely absorbed on the 65-80th day after surgery).

The skin scar forms approximately on the 7th day after surgery; therefore, already a week after a caesarean section, you can shower completely calmly. Just don’t rub the seam with a washcloth - this can only be done in another week.

A cesarean section is a fairly serious surgical procedure in which the incision passes through all layers of the anterior abdominal wall. Therefore, of course, a young mother is worried about pain in the area of surgical intervention.

In the first 2-3 days, painkillers, which are administered to the woman intramuscularly, help to cope with painful sensations. But from the first days, to reduce pain, the mother is recommended to wear a special postpartum bandage or tie up her stomach with a diaper.

After a caesarean section, young mothers often have a question: will the seam come apart if you take the baby in your arms? Indeed, after abdominal operations, surgeons do not allow their patients to lift more than 2 kg for 2 months. But how can you say this to a woman who has to take care of a baby? Therefore, obstetricians do not recommend that parents after a cesarean section lift more than 3-4 kg during the first time (2-3 months), that is, more than the weight of the child.

Possible complications

If pain, redness, or discharge from the wound appears in the area of the suture on the perineum or anterior abdominal wall: bloody, purulent, or any other, then this indicates the occurrence of inflammatory complications - suppuration of the sutures or dehiscence. In this case, you need to consult a doctor.

Depending on the severity of the condition, the doctor will prescribe local treatment for the woman. In the presence of purulent-inflammatory complications, this can be Vishnevsky ointment or Synthomycin emulsion (they are used for several days), then, when the wound is cleared of pus and begins to heal, Levomekol is prescribed, which promotes wound healing.

Once again, I would like to emphasize that treatment of complications should only take place under the guidance of a doctor. Perhaps a midwife will come to the patient’s home to treat the sutures, or maybe the young mother herself will have to go to the antenatal clinic, where the procedure will be performed.

Exercises for healing stitches

To speed up the healing process, whenever possible, you should try to tense your pelvic floor muscles to increase blood flow. An example of such an exercise: contract the muscles around the vagina upward and inward as if you need to stop the flow of urine. Maintain this position for a count of 6. Relax. Such exercises can be repeated several times a day, alternating tension and relaxation 5-8 times.

Childbirth does not always go flawlessly; if it is accompanied by ruptures, then stitches are required. This also applies to caesarean section, but you shouldn’t worry too much - although the presence of stitches has a certain impact on the quality of life, over time the body recovers. In this situation, how long it takes for the sutures to dissolve after childbirth is directly related to where they are located.

Location of seams

They can be placed either in the vagina, in the perineum or on the cervix.

Absorbable materials are used for this; the operation itself is performed either under intravenous anesthesia, or after treatment with Novocaine or Lidocaine. The choice of pain relief depends on the number of tears and their size. A certain amount of soreness in the suturing area is present, regardless of whether the perineum or vagina is sutured. In this regard, sutures on the cervix cause the least discomfort. Being inside, they are not as painful as external stitches, which are felt with every movement.

Sutures in the perineum can be a consequence of both ruptures and artificial dissection. The latter heal easier. They also differ in severity:

Skin tears at the posterior commissure are considered the mildest;
moderate severity of rupture of vaginal skin and muscles;
the most severe are ruptures accompanied by injury to the walls of the rectum. In this case, it is best to ask your doctor about how long it takes for sutures to heal after childbirth.

How are the stitches sutured?

First, the issue of anesthesia is decided, so you should not be afraid that this will be done “live.” Although often the release of adrenaline into the blood after childbirth is so great that even stitching without anesthesia does not feel as painful as childbirth itself. Sutures are applied to the perineum in layers, first the internal injuries are sutured, then the muscles and lastly the skin. Non-absorbable materials can be used for it. For greater safety, such threads are impregnated with antibiotics so as not to cause an inflammatory process. Removal of superficial sutures is usually carried out before discharge from the maternity ward. The internal sutures dissolve on their own.

Suture after caesarean section

It requires special mention. Depending on what kind of incision is made, longitudinal or transverse, the suture can be intradermal cosmetic or nodal. The latter is applied during transverse dissection, as it is more durable. In this case, the healing of sutures after childbirth takes longer. Both types of suture are quite painful, but the internal subcutaneous one has a more aesthetic appearance. Regardless of which suture is applied, antibiotic therapy is mandatory. The scar forms on the skin approximately 7 days after the operation, at the same time the silk external sutures are removed. The internal ones dissolve on their own, 2-3 months after birth, without causing discomfort to the mother in labor. The main problem with sutures after cesarean section is the possibility of formation of adhesions. It is impossible to prevent them with a guarantee, but it is believed that an active lifestyle, naturally within reasonable limits, helps normalize blood circulation and normal restoration of the body. Therefore, it is recommended to get out of bed as early as possible, as soon as the doctor allows it, regardless of pain in the suture area and fears associated with its strength.

Suture dissolution time

The main indicator of what determines how long it takes for sutures to heal after childbirth is the type of thread with which they were made. If the base material for them is catgut, then the duration of the resorption period can vary from a month to four. The location of application and the diameter of the thread also have a significant influence on this. Dacron threads dissolve much faster, from one and a half weeks to two months. Seams with vicryl threads disappear in 2-3 months. Do not confuse the timing of suture resorption with the timing of wound healing. For the latter, one and a half to two weeks is enough, while the sutures dissolve much later. If they are not made of threads, but in the form of metal brackets, then removal is indispensable. Typically, braces are removed 5-7 days after birth. You should not worry about the pain of this process; most often it causes nothing more than discomfort. The place where the stitches are placed can hurt much longer than the actual removal of the stitches after childbirth.

Complications of postpartum wounds

Alas, they also occur and the size of the seam is not the most important indicator here. The most common complication is suture dehiscence. Most often, this occurs with external seams, and the reasons for this may be the following:

sudden movements;
squats and premature landings;
inflammatory processes;
sex life.

If the stitches are placed on the perineum, then you cannot sit down fully in the first days. In the best case, you can sit down on the lateral surface of the thigh in order to eliminate the load directly on the site of the suture. Ideally, it is best to either stand or lie down.

It is not difficult to understand that removal of stitches after childbirth will not be necessary, since the latter have come apart. The first sign of this phenomenon is a feeling of inflammation, bleeding or severe discomfort. It is not at all necessary that the sutures should “burst”; much more often there are situations where, due to the load experienced, they diverge slightly, this area becomes a gateway for infection, and then events develop more than typical. First, there is a feeling of distension in the area where the suture is applied, then inflammation is felt even on palpation, often painful; this process may be accompanied by an increase in temperature. In particularly aggravated cases, purulent discharge may be present, but for them to appear, you need to significantly improve your health. Therefore, if there are doubts about the quality of the seam, or unpleasant sensations in its area, you should not wait for discharge. A timely visit to a gynecologist will help to avoid many problems in the future, simplify treatment and get as close as possible to answering the question of how long it takes for sutures to dissolve after childbirth.

Caring for seams

In a maternity hospital, it rests entirely with medical workers. The classic scheme is a daily examination, rinsing with antibacterial drugs, and treatment with wound-healing drugs. The most characteristic and frequently used among them is the common brilliant green. Sutures inside the uterus or vagina do not require special care, but following simple rules that are relevant after childbirth is only welcome. Therefore, to avoid infection, you should abstain from sexual activity until the discharge is over and the sutures are reabsorbed, do not expose them to excessive heat, and do not soak them. Therefore, you can forget about a bath for the next few weeks, just a shower. Particular attention should be paid to nutrition, since in case of problems with stool, excessive impact on the damaged area is obvious. In order to prevent possible constipation, you need to plan the menu so that it does not contain an excess of flour products. But you should also be more careful with vegetables: an upset stomach in this situation is absolutely unnecessary.

Regardless of how long the sutures dissolve after childbirth, high-quality intimate hygiene is mandatory. It is advisable to wash your genitals after each visit to the toilet. There are no special requirements for the treatment of sutures after a cesarean section, since it is assumed that doctors discharge a woman from the maternity hospital only after they are finally convinced of the consistency of the suture and other indicators characterizing the patient’s normal recovery.

When does it stop hurting?

The scar after a cesarean section becomes barely noticeable almost half a year after the suture is applied. Before this, sensations of heaviness, spasms and “whining” in this area are quite possible. Sutures in the perineum do not require such a long recovery time, but here, too, much depends on the woman herself and on how strictly she follows the doctor’s recommendations. There are often situations when, even after the sutures have been absorbed, a certain dryness and tightness of the vagina is felt, which is most pronounced during lovemaking. Fear of pain can be a significant barrier, but two months after suturing, it is not only possible, but necessary to try. And it is not so important how long the sutures dissolve after childbirth; the recommendations of the attending physician and self-confidence are much more important. Despite the fact that the mother’s body has undergone significant changes, this is not a reason to deny herself intimate relationships. The use of lubricant and a more careful attitude towards the woman will help smooth out the situation in the first days.

When delivering a baby vaginally, doctors sometimes have to resort to perineotomy or episiotomy - cutting tissue from the opening of the vagina back towards the rectum or at an angle to the midline. Sutures in the perineum after childbirth require special attention from doctors and the young mother’s compliance with certain recommendations.

Read in this article

Why do they need stitches?

Perineotomy is an operation that protects the mother and helps the baby to be born. In the second stage of labor, excessive stretching of the perineal tissue may occur, and there is a threat of its rupture. This happens in the following cases:

high crotch;
inflexibility of tissues in women giving birth for the first time after 30 years;
scars from previous births;
the position of the child during childbirth, when he faces the perineum with his forehead or face (extensor presentation);
use of obstetric forceps or vacuum extraction of the fetus;
large fruit;
rapid labor;
premature eruption of the head due to improper management of labor by a midwife.

A cut with straight edges heals better than a tear. Therefore, a dissection of the perineum is performed, followed by suturing after the birth of the child. The wound is sutured to speed up its healing.

Precautions in behavior after the incision

The length of the tissue dissection is about 2–3 cm; after suturing, the incision heals quickly. To prevent this process from slowing down and becoming more complicated, a young mother should take some precautions:

on the first day after birth you should only lie down;
standing and walking are allowed from the second day, for example, a woman must eat at a special high table, which is in the dining room of the maternity hospital;
you can sit only 3 days after the stitches are removed or 2 weeks after giving birth, first on chairs and then on a soft bed or sofa;
The newborn should be fed while lying on the bed;
properly care for the perineum;
avoid constipation;
wear cotton underwear that is not tight.

When are stitches removed after childbirth? This usually happens a week or less after the baby is born. Thus, a woman should be careful in the first 14 days of the postpartum period.

If the sutures are applied using self-absorbing material, then they do not need to be removed. The woman is discharged home at the usual time; the synthetic threads in the incision area completely disappear after a few weeks. The nodules disappear within 2 weeks after birth.

Proper care of intimate areas and stitches

How to treat sutures on the perineum after childbirth? The use of special antiseptics is not required. After visiting the toilet, a woman should wash herself with warm boiled water from the perineum to the anus and dry the skin with a clean cloth or paper towel. After washing, it is recommended to lie on the bed for a while without a pad so that the seam area dries well.

It is also necessary to change postpartum pads at least every 2 hours to prevent infection.

If you follow these simple tips, an incision in the perineum is not dangerous. After it, only a small scar remains. If a cosmetic suture was applied, then traces of it are practically invisible.

The use of medications to care for sutures is required if healing is slow or complications develop. These medications must be prescribed by a doctor. Usually they use treatment with chlorhexidine, hydrogen peroxide, less often they recommend ointments - “Levomekol”, “Vishnevsky Ointment”, “Solcoseryl”, products with panthenol.

Exercises for speedy recovery

To speed up tissue restoration, you can perform special gymnastics. It should be remembered that before the sutures are removed, you cannot perform exercises with abduction (breeding) of the legs.

In the first two days, the exercises are performed while lying in bed. They include bending the legs at the ankle joints, and then at the knee joints. Subsequently, lifting the pelvis with support on bent legs is added. Breathing exercises are also useful. Class duration is 15 minutes.

On subsequent days, gymnastics is performed standing and its duration increases to 20 minutes. Turns and shallow bends of the body, standing on tiptoes, and light squats are added. Periodic contraction of the anal sphincter throughout the day and attempts to temporarily stop the stream of urine during urination are indicated. Such exercises help restore blood supply to tissues and speed up healing.

Causes of seam divergence

Some women still experience suture dehiscence after suturing the perineal incision. The reason for this is the woman’s failure to comply with the recommendations for the regimen:

getting out of bed early;
sitting for a long time during the first week after birth;
incorrectly performed exercises during gymnastics.

In addition, the sutures also come apart if the postoperative wound becomes infected.

Symptoms that should alert you

If a woman has pain in her stitches after childbirth, she should tell her doctor. This is one of the main symptoms of a wound not healing. In addition, signs of trouble may include:

bleeding from the incision;
feeling of fullness in the perineum;
tissue swelling;
fever, chills, weakness;
purulent discharge;
formations under the skin in the form of tubercles or bumps.

In all these situations, it is necessary to contact an antenatal clinic. Otherwise, the sutures will hurt for a very long time, and after the wound heals, deformation of the walls of the vagina and perineum will remain.

Methods for correcting abnormal skin fusion

The perineum is usually sutured with two rows of sutures: the first is placed on the muscles, and the second on the skin. If only the superficial suture has come apart, measures are taken to prevent infection (treatment with chlorhexidine, hydrogen peroxide, brilliant green and other antiseptics); re-suturing is not performed.

If a woman’s entire stitch really comes apart, the cause is usually purulent inflammation. In this case, severe pain, fever, and purulent discharge occur. In this case, you need to urgently consult a doctor; surgical treatment of the wound will probably be required.

In case of significant deformation remaining after a deep seam has opened, it is further indicated.

So, sutures are placed on the perineum after childbirth to speed up the healing of the tissue incision. If the woman follows the rules of care and takes good care of her health, her well-being quickly returns to normal. If disturbing symptoms appear, you should seek help from a gynecologist.

What will you learn from the article about postpartum stitches:

1
Types of postpartum sutures;
2
How long does it take for sutures to heal after childbirth?
3
Features of caring for sutures on the perineum;
4
How to care for a suture after a caesarean section;
5
Features of the regime for seams on the perineum;
6
How long should you not sit down with stitches in the crotch;
7
In what position to feed a child with stitches in the perineum;
8
Features of the regime for sutures after cesarean section;
9
How long do stitches bother you after childbirth?
10
Possible complications of postpartum sutures.

First, let's figure out what types of seams there are, since each type of seam may require its own restrictive measures and care features.

So, after childbirth the following types of sutures are possible::

suture after caesarean section- a transverse incision is currently being made in the lower abdomen, which corresponds to the lower segment of the uterus, 12-13 cm long and contains 2 sutures: an internal one - the uterus is sutured, and an external one, which we see on the skin.
stitches on the cervix- these are internal sutures that are applied in case of rupture during physiological childbirth. The reason for this may be incomplete dilatation of the cervix, rapid labor.
stitches on the vaginal walls- internal sutures, which are applied in case of vaginal rupture, which also occurs during rapid labor and inflammation of the vagina - in this case, the walls become inelastic and are easily injured.
crotch seams - external. They are applied for rupture of the perineum of varying degrees and for episiotomy (artificial incision of the perineum). The causes of rupture and episiotomy are rapid labor, high position of the perineum, breech presentation of the fetus, and others.

Regardless of location, seams can be divided into internal and external. No care is required for the internal ones; they are performed with absorbable threads and heal on their own.

External seams differ only in the suture material with which they are made, and regardless of the location of the seam and the technique of its implementation, they require proper care.

How long does it take for stitches to heal after childbirth?

The speed of healing of sutures depends on several factors. Whether the wound is lacerated or cut. From suture material, which may or may not be absorbable (threads that require removal, or metal staples). From certain concomitant diseases that impair the healing of any wounds. And also from seam care and personal hygiene.

Stitches on lacerated wounds always take a week longer to heal than on cut wounds. Postpartum sutures with the application of absorbable materials heal in about 10-15 days, and dissolve in another week. Sutures using threads that require subsequent removal heal after 15-20 days, and dissolve within a week after healing. Sutures for which metal staples are used heal in 3-4 weeks and dissolve within 1 week.

The healing of sutures can be worsened by: concomitant diabetes mellitus, massive blood loss, anemia, flabby muscles and skin, etc.

How to care for a postpartum suture?

Internal seams do not require special care. The internal suture after a cesarean section is covered with skin and does not come into contact with the environment.

And with sutures on the cervix and vagina, it is necessary to promptly empty the bladder and bowels, maintain intimate hygiene and not lift weights. In most cases, these sutures are applied with absorbable sutures and do not require removal, but heal and scar on their own.

External seams are in contact with the environment, so there is a risk of infection, and such seams require careful care.

The suture after a caesarean section is looked after by medical staff for the first few days while the woman is in the maternity hospital. The suture is treated daily with an antiseptic and a sterile bandage is applied. On average, the sutures are removed after a week, after which treatment is continued until complete healing.

The woman is very worried about the stitches on the perineum. It is impossible to apply an aseptic bandage to these sutures; these sutures make themselves felt with any emptying and require very careful care. After each urination and defecation, you must wash yourself with running water at room temperature without soap.

Twice a day, morning and evening, wash the seams with soap, but do not rub them with a washcloth. Then dry the skin in the seam area using blotting movements. It is best to use disposable paper towels for this. But you can get a towel only for the crotch, and change it every day. After water treatments, do not rush to put on underwear; air baths promote tissue regeneration.

You cannot wear synthetic underwear - only cotton, or special disposable underwear is a good option.

You should not wear shapewear; it interferes with proper blood flow, which is necessary for the healing of the seam.

It is necessary to change the gasket at least once every 2 hours, even if it is not full, microorganisms simply multiply in it.

These sutures do not need to be treated with antiseptics and antibiotic ointments without indications; they are used only when the suture is suppurated. For care, you can use products that promote rapid tissue regeneration, but do not contain an antiseptic or antibacterial component: bepanten, sea buckthorn oil, etc. When suppuration occurs, the suture is treated with antiseptics (brilliant green solution, chlorophyllipt, chlorhexidine, etc.) and ointments with antibiotics (levomekol, oflocaine, etc.). But if the suture becomes infected and inflamed, it is necessary to be examined by a doctor, since inadequate treatment can lead to complications in the form of inflammation of the internal genital organs.

If a dense, inelastic scar is formed, the doctor may prescribe special absorbable ointments that are applied daily to the scar area for several months.

Features of the regime for postpartum sutures

Our biggest fear is that the seam will come apart. Therefore, with postpartum sutures, it is necessary to take precautions to prevent their divergence. Two components play a leading role here: timely bowel movements And preventing constipation, and limiting physical activity.

Constipation leads to the need to strain when defecating, and this risks the sutures coming apart. Constipation also leads to the proliferation of saprophytic flora, which increases the risk of infection of the suture.

You should try to regulate your stool as much as possible with your diet, but with the need to adhere to a strict diet, this is not always possible. To soften the stool, a nursing woman can eat at least a glass of any fermented milk product (yogurt, kefir, fermented baked milk, acidophilus, etc.) and 1 tsp milk thistle fiber every day. up to three times a day with meals and drink plenty of fluids. In the first three days, you can do an enema or put a glycerin suppository with every urge to defecate. If constipation still occurs, then it is necessary to do an enema to empty the intestines.

A woman should not lift weights for two weeks. Also, with stitches on the perineum, the most important restriction is a ban on sitting for at least 2 weeks. And this is perhaps the most difficult moment. This would be easier if a woman after giving birth did not have to care for a newborn baby and a family. And you also need to somehow get home from the maternity hospital. It is recommended to ride in a car lying down, standing or reclining on your healthy side. It is necessary to rise from a lying position to a standing position, bypassing the seat. You need to get up in a position on your side through the healthy side (opposite from the one on which there are stitches), then get on all fours and thus go down to the floor.

You can sit down slightly on the toilet, but place the main support on your healthy side.

You cannot squat or make any sudden movements. All movements should be soft and smooth.
You can start sitting down after two weeks, if there are no concomitant diseases that impair tissue regeneration, and only on a hard surface. And only after a week - to the soft one.

If a woman gave birth through a cesarean section, then for the first 2-3 days, as a rule, analgesics are administered to reduce the intensity of pain in the area of the postpartum suture, and then it is recommended to wear a special bandage or tighten the abdomen with a diaper or, even better, a long elastic bandage.

After any abdominal surgery, surgeons do not recommend lifting weights exceeding 2 kg. It would be ideal to follow this recommendation for the postpartum woman. But this can only be done with outside help, if someone close to you takes full care of the baby, and the mother is brought in only for feeding. And so on until the suture heals - on average 2 weeks. If this is not possible, then it is recommended not to lift anything more than the child’s weight (3-4 kg).

In what position should you feed a baby with stitches in the perineum?

It is also necessary to feed the baby while lying down. A very comfortable position in which the mother lies on her side and places the hand on this side behind the baby’s back or behind her head. And the baby is on the other side, facing his mother, with his tummy pressed against her. In this case, you need to put a comfortable pillow under your head. You may also need a pillow or bolster made of any fabric under your back in the pelvic area or between your knees.

1.5-2 weeks after birth, you can feed the baby in your arms, reclining, but very carefully.

How long do stitches bother you after childbirth?

The stitches may continue to bother you for months after healing. And the intensity of pain decreases on days 5-7 with successful healing. But if the pain lasts longer, or has intensified, if there is suppuration of the suture, bleeding from the suture, or a rise in temperature, then this is a mandatory reason to consult a gynecologist.
After 2-3 weeks, itching and a slight feeling of tightness may occur, which indicates resorption of the suture.

With stitches in the perineum, discomfort, a feeling of tightness and pain during intercourse are possible for several months to six months.

Within two weeks, the pain in the area of the sutures should stop, but sometimes it happens that after this time, the sutures continue to bother the woman, accompanied by pain, discomfort, bleeding, unpleasant odor, suppuration, or suture dehiscence. And any of these conditions is a reason to consult a doctor.

Possible complications of postpartum sutures:

Pain. If after two weeks the pain persists, and a medical examination does not reveal any objective causes of the pain, then warming up using an infrared, blue or quartz lamp may be prescribed. The session lasts for 5-10 minutes from a distance of 50 cm. Warming up can begin no earlier than two weeks after birth. If procedures are started earlier, this may cause uterine bleeding. Warming can be done independently at home, but only with a doctor’s prescription after an examination.
Special ointments for scar resorption may also be prescribed.
Seam divergence. If the seam comes apart, then two options for further tactics are possible. It depends on whether the wound has already healed or not and on the degree of suture divergence. In most cases, stitches are not re-applied, and healing occurs by secondary intention. This creates a less elastic scar. In some cases, new sutures are placed, but a new section of the skin must be made, since the sutures do not cover infected wounds. After this, local use of drugs that promote rapid regeneration is recommended.
Itching. In most cases, about two weeks after the suture is applied, the woman begins to experience itching, sometimes very severe. But, as a rule, this is not a deviation, but, on the contrary, indicates healing of the suture. Itching is accompanied by scar resorption. In this case, it is recommended to wash yourself with cool water as often as possible, but not hot!
But in some cases, if there is itching not only in the scar area, but also in the area of all external genitalia and in the vagina, this indicates inflammation or dysbiosis of the vagina.
Suppuration. If there is purulent discharge from the suture, which can be gray to green in color, with an unpleasant odor, then this condition is very dangerous due to the spread of the purulent process and requires mandatory examination by a doctor. In most cases, external treatment with antiseptics and antibiotic ointments, which should be prescribed by a doctor after examination, is sufficient. In more severe cases or with concomitant diabetes mellitus or thyroid diseases, systemic antibacterial drugs may be prescribed.
Bleeding. If there is bleeding from the postpartum suture, this indicates its insolvency, that there are areas where the edges of the wound do not close and, exposed during movements, bleed. This occurs when the seam diverges after early sitting. In most cases, this does not require special measures, and the seams heal on their own. In some cases, re-suturing is required.