Mum's guide on how to care for your postpartum wound - vaginal or caesarean delivery

Whether you gave birth via vaginal delivery or you had a C-section, it’s very important to help your body heal and recover from it properly. That’s why it’s important to know the necessary steps for postpartum wound care.

Postpartum wound care

Your desire as a mother is for your child to enter the world healthy and safe. And if that requires a normal delivery or perhaps a C-section, the incision made is a miracle of life – your precious baby.

In the following days and weeks after giving birth, most of your time and attention will be focused on taking care of your newborn’s needs. However, it is also essential to tend to yourself and tune in to your own needs as your body recovers from the childbirth process.

Over the next few days or weeks, your body will feel sore and swollen, especially the parts where your newborn came out. Your postpartum wounds are still healing and should be handled with utmost care.

You wouldn’t want to go back to the emergency room to have them stitched again, would you?

For this reason, you need to ensure that the wound heals properly and that scar tissue is minimised. Here are some tips for proper postpartum wound care for a natural birth or caesarean delivery.

Postpartum wound care for normal delivery

During labour, your perineum — the area between your vagina and rectum — may stretch and tear, which can hurt.

The postpartum pain may be worse if you get an episiotomy when your doctor makes a small cut that widens your vagina to help your baby come out.

Normal delivery stitches healing time

In a normal delivery, your perineum may require stitches to repair tears or wounds. It may take 7 to 10 days for this to heal.

Over time, the stitches will dissolve. The stitches will eventually be absorbed by your body. Meanwhile, avoid touching your stitches and contact your doctor if they get more painful, red, or leak fluid.

You may use the following tools and tips for postpartum vaginal wound care:

•     Ice packs

Ice packs are a must-have in postpartum wound care. To reduce pain and swelling at home, use an ice pack or cold pack on the affected area for 10 to 20 minutes at a time.

Ice packs that look like sanitary pads and may be worn in your underwear are available at many drugstores.

If you’re using an ice pack, wrap it in a clean cloth to keep the cold off your skin. If you use an ice pack for more than 20 minutes at a time, you risk damaging your nerves.

•     Stool softeners

A stool softener, such as docusate sodium, may be prescribed by your healthcare professional or recommended over the counter.

When you have a bowel movement, you won’t have to strain as much. If you feel the desire to go, don’t hold it in because it could lead to constipation.

•     Staying clean and dry

After birth, your medical provider will most likely give you a squirt bottle or sitz bath to keep your perineal area wet and clean.

After going to the restroom, fill a squeeze bottle with lukewarm water and use it as a rinse. Sitz baths are little plastic tubs that fit over the top of the toilet bowl. To cleanse your skin, fill the bath with lukewarm water and soak for a few minutes.

Make sure to practice proper hygiene to prevent infection from building up in your postpartum vaginal wound.

If you use toilet paper to wipe the area, you risk irritating the stitched region. Press a clean pad or washcloth on the sore area and wipe from front to back when you need to move your bowels. This will help you avoid infection while also relieving discomfort.

Contact your doctor if the wound becomes irritated or the stitches appear to be leaking. It’s possible that it’s an indication of infection.

• Avoid sitting on a hard surface

Instead of sitting on a hard surface, sit on a chair with a soft cushion or on a pillow. Also, avoid sudden movements like standing up or sitting down quickly to prevent putting more pressure on your postpartum wound.

Slowing down for at least a couple of weeks after giving birth is essential in postpartum wound care.

•  Rest

When you have a new baby, it can be difficult to rest, but avoiding rigorous exercise will help you heal. You should avoid heavy activities for at least two weeks after giving birth, according to your healthcare physician.

Don’t hesitate to accept any offers of assistance from family and friends, and try to stay off your feet as much as possible.

• Avoid products and activities that can worsen your symptoms

You should manage to stay away from the following things:

• bathing in salt
• scented lotions and talcum powder
• scalding your perineal region with hot water or hot packs
• squatting to avoid overstretching your skin
• sexual activity till the healing process is finished
• tampons (but pads can be used after delivery)
• vaginal cleansers or douches

Postpartum wound care for caesarean delivery

A caesarean section (C-section) is a major operation. Your body, like any other surgery, needs time to heal afterwards. Here are some postpartum wound care tips:

Caesarean wound healing

After your delivery, expect to spend two to four days in the hospital. Your stay will be extended if complications arise. The skin stitches should heal in five to 10 days. Your scar should look and feel significantly better after two weeks.

Your muscle layer’s underlying stitches will take longer to heal. It will take 12 weeks for these to fully heal. However, it can take anywhere between six weeks and three months to fully recover.

Any haemorrhoids that form should gradually shrink in size. Some of them might vanish. Symptoms may be alleviated by using the following methods:

• Warm tub baths (shallow enough to keep your incision above the water level).
• Cold compresses over the area.
• Over-the-counter pain relievers.
• Over-the-counter haemorrhoid ointments or suppositories.
• Bulk laxatives to prevent constipation. If necessary, ask your provider for recommendations.

Caesarean wound infection

Keep an eye out for any signs of infection in the stitches that you can see. Contact your doctor right away if you have any of the following symptoms:

• Skin redness, warmth, or oedema surrounding the incision
• Fever 
• Oozing or discharge from the location of the incision
• Foul odour in the area
• The wound hardens or you experience more pain surrounding the wound
• Tenderness or discomfort in a specific area of the incision 
• The incision splits open.

If you go home with a dressing, change it once a day to minimise infection. If it gets dirty or damp, replace it sooner (bandage),

• Your healthcare practitioner will advise you when it’s time to stop covering your wound.
• Wash the wound area with gentle soap and water to keep it clean. It’s not necessary to scrub it. In many cases, simply letting the water run over your wound in the shower is sufficient.
• Remove your wound dressing and shower if your skin was closed with stitches, staples, or glue.
• Do not soak in a bathtub or hot tub, or swim, unless your doctor says it’s okay. In the majority of cases, this does not occur until three weeks after surgery.

Do not attempt to remove the strips or adhesives that were used to close your wound. Showering and patting your incision dry with a clean cloth is fine.

In approximately a week, they should fall off. Unless your provider tells you not to, if they are still there after 10 days, you can remove them.

Ointment for stitches after delivery

Some doctors recommend applying a topical antibiotic or petroleum jelly to the wound and lightly bandaging it, while others recommend doing nothing and leaving the wound exposed.

Consult your doctor to determine which option is best for your scar.

Tips for Caesarean postpartum wound care

In four to eight weeks, you should be able to resume most of your normal activities. But first, take note of the following reminders to prevent your CS postpartum wound from opening up or getting infected. 

• Do not lift anything heavier than your infant for the first six to eight weeks.

• Take short walks to build muscle and endurance. It’s fine to do some light chores. Gradually increase the amount you do.

• Be prepared to get tired quickly. Pay attention to your body and avoid becoming overly active.

• Avoid strenuous housework, jogging, most exercises, and any other activity that causes you to exhale quickly or strains your muscles. Sit-ups are not recommended.

• Eat smaller meals than usual and eat healthy snacks in between. To avoid constipation, eat plenty of fruits and vegetables and drink eight cups (2 litres) of water per day.

ALSO READ: C-section infection: What you need to know

Postpartum wound care: When to call the doctor

Sometimes, unforeseen circumstances occur – like an infection on the postpartum wound or the stitches opening up. Call your gynaecologist or proceed to the emergency room right away when you experience the following:

• Fever
• Foul-smelling and/or greenish discharge 
• Redness and swelling around the stitches
• Severe pain at the incision site
• Visible pus in or around the wound

If you have any unusual or concerning symptoms after giving birth, or even if you just have questions about postpartum wound care, don’t hesitate to contact your healthcare provider.

This article was first published in theAsianparent.