Healing the perineum after giving birth

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Dec 022015
 

DSC_0037In one of my prenatal yoga classes the other day, one woman, expecting for the second time, said that she wished someone had spoken to her, in pregnancy, about healing postpartum. What a great idea for a theme! If you’re coming to this post as a yoga student, and new MamaNaturale reader welcome! And welcome to anyone else who’s found her way here.

Talking about tearing in labour can make many, if not most mamas-to-be, cringe. But it’s better to talk about it now, than later. For a while, episiotomies (cutting the perineum in labour) were routinely performed here in Canada. Luckily, that is a trend that is shifting. As stated by the Society of Obstetricians Gynaecologists of Canada,

“There is no evidence to support doing an episiotomy for all women (making a cut to widen the opening to the vagina). In fact, there are more benefits to NOT doing this, such as:

  • less pain after the baby is born,
  • better sexual function later, and
  • less relaxation of the pelvic muscles

In some cases, an episiotomy is necessary to relieve pressure, or to deliver a baby in distress more quickly”

There’s a good chance that in labour, you will tear, at least a little. The chances are increased if you’re pushing for an extended period of time, which is common if an epidural has been administered. You can ask for help and guidance in pushing the baby out slowly, and ask that a warm compress be used to help baby’s head ease out gently. If you do tear please know, you will heal, and it’s usually quite easy to take care of the area.

What you can do in the postpartum period:

periA Peri Bottle
Some hospitals give them out, but don’t count on it. It doesn’t have to look exactly like this, get creative. You fill the bottle with warm water/herbal tea concoction and clean the area by spraying the water, rather than wiping with toilet paper. You can also spray while peeing to reduce stinging.

Raw Honey
You can apply raw honey to the wound. It is anti bacterial.

Frozen pads
Freeze some of your maxi pads at home, the cold feels great and helps with swelling. You can also use baby facecloths, frozen, and place them on top of your pads. It feels great, I promise.

 

sitzSitz Bath
You can buy these at any pharmacy. You place it on top of the toilet, fill it with a herbal concoction that you can make on your own, or Earth Mama Angel Baby makes postpartum bath herbs containing: Sea salt, oatmeal, kernel meal, witch hazel, yarrow, plantain leaf and calendula flowers. They’re teabags that can be used in the bath  (regular or sitz) and also worn over your pad. You soak the perineal area in the basin of water or tea. Take the time to do this for yourself while someone holds baby.

 Tucks Pads
In the hemorrhoid section of the pharmacy, you can find a product called Tucks Pads. I feel they’re less than ideal because they contain alcohol, which can be drying. I did, however, use them after my first baby. With the second, I took the time to prepare my own, which was inexpensive and easy. You need:

To make these compresses, you only need: Witch Hazel, Aloe Vera, Tea Tree Oil, Lavender Oil, a box of 10 6×6 inch Medical Gauze Pads, Ziplock bag, Airtight container. Here is the site I used to make mine. I recommend checking it out, and get excited about making your own! 😉 You can find all of these items at the pharmacy, though the EOs might be of lesser quality. Try finding Witch Hazel without alcohol and pure aloe vera

Can you avoid tearing/episiotomy? Here’s a great post from my friend, Megan the Doula.

 

Feb 112011
 

Thanks to Jennifer Roberts-Hall for sharing her two birth experiences and reminding us that in pregnancy and birth plans, flexibility is the key!

By Jennifer Roberts-Hall

Jennifer's first son

I started off my first pregnancy believing that everything would go perfectly and exactly as planned.  My family, friends and midwife tried to explain to me that labour can sometimes be unexpected but I refused to believe them.  I knew exactly what I wanted to happen and thus that’s how it would be.

Boy, was I in for a surprise!

The first thing that was unexpected with my first pregnancy was that the test for gestational diabetes came out positive.  I was devastated.  I thought for sure I was the worst woman ever who was hurting her baby.

Then I found out how easy it was to manage and how as long as I watched my diet everything should be just fine. In the end, I think I was probably healthier for it.  Less potato chips and more carrot sticks for me.

I should add that I was also positive for gestational diabetes with my second pregnancy but it came with less stress on my part.

With both pregnancies I was induced because of the gestational diabetes and the fear of having “too big” a baby, a fear I myself was never concerned with.  The first pregnancy I did not want to be induced at all and convinced them to let me go at least a couple of days past my due date which they consented to.  I was induced 3 times!  The first time I had a night of painful contractions brought on by the induction but no real labour.  The second time nothing happened and finally, the third time “took” and my bambino was born 1 week after his official due date.

Baby #2

My second pregnancy I was much more relaxed about the induction, believing that my baby would only arrive once he was really ready.  Because the ultrasounds were showing my baby to be “big” (8 lbs, 14oz at 39 weeks) they decided to induce me a week early. The first time the induction brought on  some mild contractions but nothing more.

Because of an strep outbreak on the maternity ward of the hospital, no other medical inductions were scheduled until the day after my official due date. Because I really did not want a medical induction again I drank a total of 5 labour cocktails (castor oil being one of the ingredients, yuck!) over the week and on the morning after the official due date, without a second medical intervention, my bugaboo was born.

Another thing that was unexpected was testing positive for the Group B Strep (GBS) swab with my second pregnancy.  I was terrified when I heard this but again, I found out just how common it was and easily treated with antibiotics (many women opt out of the antibiotics actually but my husband and I decided to go ahead with them).  My son is now 6 weeks old and is very healthy.

Both births were vaginal deliveries, no epidurals and no episiotomies. I did take Fentanyl both times and gas.  Neither of my labours were more than 8 hours in length and I only had hard pushing for 7 minutes with my second son.

I tore and required stitches both times but they easily healed. And in both cases my sons weighed in at 9 lbs exactly.  Not small babies but in my opinion not extra large either-they looked tiny (and beautiful) to me!

The reason I want to share this story with you is that I think it is important to remember that in the end, the most important thing is that you are healthy and that your baby arrives into the world healthy.  You need to try not to stress over all the small details but still weigh all your options with every decision and write your birth plans with flexibility.

Because you CAN have the birth YOU want but sometimes it just takes a bit of adjusting to the plan to get there.

You can Read Jennifer’s blog Jennifer’s Story and follow her on Twitter.

Feb 012011
 

Dear hospital staff,

Please don’t touch me unless it’s a medical emergency.

Sincerely,

Jenn Hardy

I thought about writing this, and decided it would be a bad idea. I’m actually debating whether or not I will bring a birth plan with me. I certainly don’t want to march in there with my doula, birth ball and a big sign that says “I’m here to be a pain in your ass.”

But I’m also not comfortable “winging it” as there are many things that I feel very strongly about going into the hospital to have this baby.

For example: Do not give me an episiotomy. Unless it’s an emergency and they’ve got to go in with forceps or a vacuum, there isn’t a need for an episiotomy. Naturally occurring tears will heal faster and better. I do not want someone to come at my vagina with scissors. Our bodies were meant to do this.

I do not want to be offered an epidural. Not only do I not want one, I do not want to be offered one. I’m a big girl. If I decide I want one I can ask for it. No drug pushing needed.

I do not want to be hooked up to an IV “just in case.” Most of the time hospitals like to hook you up, but it seems to cause more problems that wouldn’t happen if you were allowed to freely move. Full mobility is very important to me. I want the freedom to use the bath and shower throughout my labour. With that said, my hospital seems to like opening a vain with a little plug not attached to an IV. If saying yes put the plug in my arm will help things run smoothly, cool. The thought doesn’t actually bother me.

Continuous Fetal Heart Rate Monitoring. Unless the mother has a health problem, or is on drugs during labour that will potentially slow down the baby’s heart rate (Pitocin, epidural etc.) it doesn’t seem like there’s a reason for continuous monitoring. Have you ever been strapped to one of those things? Makes me crazy after 5 minutes, I can’t imagine it being done for hours. I think it makes much more sense for the nurses to check periodically. But that means time in a crowded hospital wing that they likely don’t have.

I do not want to be pumped with Pitocin or any other labour- inducing drug if my body isn’t doing things as quickly as you want it to. If my baby’s in danger, cut her out for all I care, but do not put me in an assembly-line mold. Close the door and give me some time to fool around with my partner. Let’s see if we can’t make real oxytocin.

Also, I am a believer in Delayed Cord Clamping. I do not desire a Lotus Birth (I must admit, I am intrigued) I have no plans to fry up and eat my placenta, but it is very important to me that the cord stops pulsing before it’s clamped and cut.

With all of this said, this is my wish list. This is my perfect, everything has gone according to my natural birth plan plan. But I am more realistic than that. I know you can not predict what will happen in labour. It’s nature and it’s unpredictable.

Isn’t that exciting!

I believe that birth is one of the most natural things in the world. I don’t personally feel a hospital is the right place for it, unless there is an emergency. MOST of the time, it isn’t an emergency.

In the end, as long as this baby is born healthy and I don’t die, we’ve all done a good job. I will not have a birth attended by a midwife at home or at a beautiful Quebec birthing centre. We will have to go to the hospital on labour day, and if interventions are legitimately needed, they’re needed.

A hospital (nice, clean, friendly, renovated hospital) is where this baby will be born, and I think I’ve finally accepted it.

Just please don’t touch me unless you have to.