How Long Does A 4 Degree Wound During Childbirth Recover?
Because it’s been more than 3 months, there is still pain in the former stitches. How long does a 4 degree wound during childbirth recover?
Hello Rahman La Ode,
The process of giving birth through the vagina can cause injury to the birth canal, including the perineal area (tissue between the mouth of the vagina - the mouth of the anus). Perineal area is the area most under pressure by the lowest part of the baby, the skin and perineal tissue can stretch to a certain extent until a tear occurs when the bottom of the baby comes out (for example the head).
Perineal tears can be classified into 4 degrees namely:
Degree 1: only concerning the vaginal and skin epithelium
No need to sew
Heal alone within a few weeks. At the beginning the patient will feel sore when urinating, when urine hits the injured part.
Degree 2: concerning the vaginal and perineal muscles
Perineal suturing is required
Heal within a few weeks
Degree 3: injuries such as degree 2 but wider to affect the anal sphincter muscle
Requires more complex suturing techniques, usually performed by obstetricians in the operating room
Complications: faecal incontinence, painful intercourse
Grade 4: the heaviest tear, affecting the vaginal area, the perineal muscle, the anal sphincter (the muscle that pinches on the outside of the rectum - to hold the bowel), to the anus wall - the rectum (the upper part of the rectum).
Generally requires management in the form of repair measures in the operating room by an obstetrician to correct all damaged muscle walls and other tissue, and minimize long-term complications.
Wound healing takes a long time> 1 month, and often complications arise after the wound heals.
Complications: chronic pain in the perineum when sitting / standing, pain when urinating, fecal incontinence (feces coming out without feeling), chronic pain during intercourse, quality of life of patients who are disturbed due to these complications
Perineal tears in degrees 3 and 4 are the competence of obstetricians. Please consult further with your obstetrician or doctor who is treating you when the delivery process is carried out to get further examination and treatment if needed.
Some physical exercises or physiotherapy that can help patients with a history of grade 3 and 4 perinerum rupture are:
If a new wound / new birth: avoid heavy activity in the first week. Try to bed rest. Avoid standing or sitting long in the first days
Maintain cleanliness of the pubic area so that the stitches are not damaged / detached
Avoid heavy lifting, running, or other activities that cause increased pressure in the perineal area for at least 3-6 months after suturing grade 3 or 4 perineum
Sexual intercourse can be done when the wound is completely dry and the wound tissue has closed properly. Make sure to do good foreplay so that enough lubrication or use additional water-based lubrication
Because of fear of pain, patients often hold urinating or defecating as a result of frequent urinary retention (urinary retention cannot get out) or constipation. Drink enough water, do not hold urinating / defecating, eat high-fiber foods, use a comfortable position when urinating / defecate (some patients feel comfortable in a sitting position with legs propped up so that the knee position is slightly higher and the body can lean forward)
Special gymnastics to train pelvic floor muscles
Thus the explanation from me, hopefully useful.