SafeMotherhood
safe motherhood

LOOKING AFTER YOURSELF

Caring for stitches

If you had an episiotomy (surgical cut) to enlarge the vaginal opening during delivery, or a tear to your perineum (the area between vagina and anus), you will probably have some stitches to look after. Here's how to make yourself more comfortable.

• Keep the perineum clean. After you've been to the toilet, use a small jug to trickle warm water between your legs as you sit on the toilet. (Peeing during a bath or a shower also helps to minimise the pain!) Pat dry - using a hairdryer to dry your perineum is no longer recommended. Excessive drying interferes with healing and blowing warm air over a wound may cause infection.
• Have a bath when you can. Research has shown that bathing in plain water is just as good as bathing in water to which salt or antiseptic has been added.
• You may find that adding a few drops of lavender oil to your bath is very soothing.
• Change maternity pads frequently.
• Use high-waisted, cotton knickers or disposable briefs.
• Sit on something soft. Protect your pillow with a towel. If your perineum is
really sore, consider hiring a Valley Cushion from your local NCT branch.
Call the NCT Enquiry Line on 0870 444 8707 to find your nearest branch. You
can get further information on Valley cushions
• Gel pads are cooling mini 'cushions' which are designed to relieve the pain and discomfort many women feel following the birth of their baby. They act immediately, contain no drugs and are worn discreetly like a panty liner. To find out more, or to purchase, contact NCT Maternity sales by clicking on 'shop' above.
• Keep moving. It may sound harsh, but getting out of bed and walking around as soon as you feel able helps your circulation and reduces swelling.
• You may find pelvic floor exercises impossible to start with but in the medium term exercising the pelvic floor does seem to make things more comfortable.
• Consider taking arnica. Although there is no strong research to say it's effective, many women feel that taking arnica tablets reduces bruising and stimulates healing.

If these measures aren't helping, and your perineum is really painful, tell your midwife. Sometime stitches are inserted too tightly and need to be removed. Your midwife may also offer you a local anaesthetic cream to use on the painful areas. Don't suffer in silence!

Pelvic floor exercises

• Pull up around the vagina as if to hold in a tampon or to stop wetting yourself. Hold for a count of four and release. You should feel the difference when you let go.
• Repeat the exercise in batches of six or eight as often as you can during the day.
• As well as holding for a count of four, try doing some where you squeeze, release, squeeze, release quite quickly.
• Keep breathing normally throughout. As soon as possible after delivery, start doing pelvic floor exercises. If you have stitches you will be sore, but the exercise will improve your circulation and help your perineum heal. Even if you have had a Caesarean, you still need to do your pelvic floor exercises.

Warning

• Start exercising very gently in the first few weeks after the birth.
• Never lie flat on your back and lift both legs in the air.
• Never lie flat on your back and do sit-ups with your feet held down.

Pelvic rock

Lie on your back with knees bent and feet flat on the floor. As you breathe out, rock your pelvis so that the small of your back flattens onto the floor. Then rock your pelvis again so that your back is lifted away from the floor.

Leg slide

Lie on your back, knees bent and feet flat on the floor. Put your hand in the small of your back, flat against the floor. As you breathe out, let your legs slide slowly forwards, bringing your knees closer to the ground. Then gently slide your legs up again.

Six weeks after the birth, when your GP has checked that you are fully recovered, join a postnatal exercise class. This is a really good way of making friends and keeping fit.

Pacing yourself

Being a new mum is exhausting! Here are some women's recollections about how the birth affected them, physically and emotionally:

"I was longing to leave hospital, although the nurses suggested I'd be better off staying in as long as possible. After two days I went home and had asked the whole family to be there on that day. But just bringing Jack home in the car was stressful and exhausting enough. When I got through our front door I was so relieved and emotional and exhausted that I went straight upstairs to sleep, leaving them to celebrate without me, which made me feel miserable and inadequate! With hindsight, I'd definitely leave it a few days before inviting everyone over." Liz

"I had a tendency to think that I still had the same energy levels that I had previously. I got frustrated with myself when I couldn't match my aspirations of what was achievable. Now I know that I was really doing well if I had a shower and got into my clothes every day." Helen

"The first time I went for a walk outside on my own with Theo in his pram, the 'outside world' suddenly seemed very noisy and I felt very vulnerable. Walking up the hill to our house I felt as though my insides were collapsing! It was only a week after he'd been born. Although it's good to get out and get some exercise, I think I should have left pushing the pram up a hill until later." Kerry

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