NHS Suffolk and North East Essex - After Birth Booklet

16 Perineal care When your baby is born, his or her head stretches the opening of the vagina. The skin inside and surrounding the vagina will often stretch well to allow your baby to be born, however during this process it is common for women to sustain a tear to the skin, inside the vagina or both – which may require stitches. The stitches used will always be dissolvable and should not need to be removed. • first degree tears affect the skin of the perineum/vagina. Some of these tears require stitches and some may heal well without stitches. Your midwife will advise you on this after birth • second degree tears affect the skin and muscle of the perineum/ vagina. Most of these tears require stitches to assist with healing • third and fourth degree tears affect the skin and muscle of the perineum/vagina, as well as some of the structures associated with the anal sphincter. These tears require an operation in theatre to repair them • labial tears occur to the labia minora, and will often require sutures to aid healing. Your midwife will advise you on this after birth • episiotomies are sustained during the birth, when your doctor or midwife makes a cut to facilitate the birth of your baby. These are similar to second degree tears and will require stitches. Perineal after-care • always wash your hands before caring for your stitches, particularly if anyone in your household has a cough or cold • shower or bath daily if possible for the first two weeks. Prolonged bathing can cause the stitches to dissolve too quickly. Rinse with warm water and avoid soaps and perfumed products. Dry with a clean towel and avoid rubbing the area