How is a postnatal stitch check done, how do stitches heal, what is home care, and when should you seek care without waiting? Balanced information.
A postnatal stitch check is the follow-up of how the area repaired after a perineal tear or an episiotomy during birth heals in the postnatal period. The mild pain, tightness or itching expected at the stitch site tends to ease over time; if it increases or lasts longer than you expected, this needs attention.
What are postnatal stitches/perineal repair and why are they done?
During birth a tear can form by itself in the perineal area, and there may also be a cut (episiotomy) made by the health team for a particular medical reason. An episiotomy is not done routinely. Perineal tears can be superficial or deeper; your health team explains to you what type of repair was done and what it means for you.
How do the stitches heal, and do they dissolve by themselves?
The stitches used are generally of the type that dissolves by itself, so there is no need to return to hospital to have them removed. The type of stitch and the time it takes to dissolve can vary from person to person and an exact time cannot be given beforehand; your health team will give you information. How the healing is progressing is assessed at your postnatal check-up.
Are pain, tightness or itching at the stitch site normal?
Pain, a feeling of tightness or itching at the stitch site can be an expected part of the healing process and are expected to lessen over time. If these symptoms are increasing, or if the pain cannot be controlled with painkillers, contact your health team the same day.
How do you care for the stitch site at home?
General care principles include keeping the area clean and dry and continuing pain management as your health team recommends. Avoid home or herbal remedies that have no evidence behind them; it is sensible to confirm your care advice with your health team.
How are the stitches assessed at the postnatal check-up?
At your postnatal check-up the general healing of your stitches or cut is also assessed; the general framework of this assessment is part of your postnatal follow-up. If you notice a problem with your stitch site between check-ups, you do not need to wait for the next appointment.
Is extra follow-up needed for deeper repairs?
For deeper repairs, your health team may recommend an extra check or a pelvic floor assessment. This is determined by your doctor or midwife according to the nature of your repair and your healing.
What can you ask your health team at the stitch check?
- What will the expected healing process be for me?
- How do you recommend I care for my stitch site at home?
- If a deeper repair was done, is extra follow-up needed?
- Which symptoms should make me contact you without waiting for my postnatal check-up?
- Do my toilet habits affect my stitches, and how should I behave?
Frequently Asked Questions
When can I go back to sex while the stitch site is healing?
According to the NHS page in the UK, there is no set time to start having sex, and it is advised not to rush. It states that there may be pain during sex after a tear or episiotomy, that in this case talking with your partner is advised and that closeness without penetration is an option. If the pain continues, consult your health team.
Do pelvic floor exercises help the stitch site heal?
According to the NHS, pelvic floor exercises strengthen the muscles around the vagina and anus, support healing and reduce pressure on the stitch site. If you are not sure whether you are doing the exercises correctly, your midwife can show you.
How can I ease my stitch site in the toilet?
The NHS recommends rinsing the area with warm water after the toilet and gently wiping from front to back. Gently pressing a clean pad against the stitch site while opening your bowels can ease the pressure. If opening your bowels is painful or you are straining, consult your health team.
Is an episiotomy done routinely in every birth?
No. It is a cut made for a particular medical reason; it is not done routinely. Tears that form by themselves can also be superficial or deeper.
Must I return to hospital to have the stitches removed?
Generally not; the stitches used are mostly of the type that dissolves by itself. You can find out the type of your own stitches and the follow-up from your health team.
Is there a set time for the stitches to dissolve and heal?
No. The type of stitch and the course of healing can vary from person to person. Progress is assessed at the postnatal check-up.
Can mild itching or tightness happen during healing?
Yes. Mild pain, tightness and itching can be an expected part of healing and should ease over time. If these symptoms are increasing, or if the pain cannot be controlled with painkillers, contact your health team the same day.
If I notice a problem at the stitch site, should I wait for the check-up date?
No. If you notice a problem between check-ups, you do not need to wait for the next appointment. Share the situation with your health team.
Should I use herbal remedies that have no evidence behind them for care?
No. The general principles are to keep the area clean and dry and to continue pain management as your health team recommends. Clarify your care with your team.
If a deeper repair was done, may extra checks be needed?
Yes. An extra check or a pelvic floor assessment may be recommended, depending on the nature of the repair and the healing. Your doctor or midwife determines whether it is needed.
Can I ask my midwife how to do pelvic floor exercises?
Yes. If you are not sure whether you are doing them correctly, your midwife can show you. You can share questions about the exercises with your health team.
If pain continues during sex, should I consult?
Yes. It is advised not to rush; if the pain continues, consult your health team. Talking with your partner and closeness without penetration are also stated as options.
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