When Do Episiotomy Stitches Dissolve?

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If you have episiotomy stitches after your baby is born, or if you had stitches after a tear, you will want to know how to care for them. This helps you minimize any pain or discomfort you may have from them. By planning ahead, you can also have specific medications or items on hand to help prepare for the postpartum period.

How to Care for Your Episiotomy Stitches

You will not necessarily need to provide any special care for the stitches (also known as sutures), other than keeping your perineum clean.

Usually, you will want to use a squirt bottle, called a peri bottle, with warm water after you use the bathroom and pat dry. The materials used by your doctor or midwife for the stitches typically dissolve on their own. This means that as you heal, the material breaks down and disappears. This can take a few weeks before it happens, so you might have even forgotten about it at first.

If you were to look at your perineum, you may notice small black stitches. Sometimes, as they are dissolving, you may notice, particularly when you wipe, that there are small pieces of the black suture material on your toilet paper. This is not a problem.

"I was so freaked out when I wiped and saw a bunch of thick black things that looked like big hairs," says Robin. "I called the doctor's office and told them it was an emergency. The nurse got on the line, by then I was sobbing, trying to figure out what was wrong with me.

I was so relieved that it was just the stitches dissolving, but I wish they would have told me before hand!"

The type of stitching done can have an effect on the amount of pain that you feel after you have a baby. Your doctor or midwife will repair the perineum and the surrounding area with a variety of possible techniques, though continuous suturing (stitching) techniques tend to produce a reduction in pain for the length of the entire postpartum period.

You can ask what type of sutures you have before you leave the hospital. 

Medications and Pain Relief for Episiotomy Stitches

There are medications that you can use to increase your comfort and some doctors and nurses also suggest a sitz bath, this is a warm, shallow mini tub that is usually fit over a toilet seat that allows water to run over the stitches for pain relief and cleansing. This can be done at the hospital or at home. Sometimes you can also use topical ointments, creams or things in your sitz bath to aid in healing and soothing. You can also try doing certain exercises right after giving birth.

"There were a lot of crazy remedies that people told me about with my episiotomy stitches," Robin continues. "One mother told me to use a hair dryer on my bottom, another had this concoction to try. I wound up going with the portable sitz bath, and a few pads frozen with some witch hazel on them. Between that and the peri bottle - I made it."

If you are particularly sore, your pain is increasing or having any problems with your episiotomy stitches, you should immediately call your practitioner for advice. You will also want to call if you are running a fever or have severe pain. Infection is possible, even in this sensitive area.

Rarely, you may need to have your stitches redone or removed. They may also be able to recommend other treatments or pain relief medications, particularly if you had an extensive repair done.

Follow-Up Care After Stitches

You will have your stitches checked by your doctor, midwife, or a nurse at your six-week postpartum visit. It is part of the comprehensive health exam to make sure that you're recovering after giving birth. Your practitioner can answer questions you have about the area, including when you can resume a sexual relationship and how to do so without pain. 

Sources:

Kettle C, Hills RK, Ismail KMK. Continuous versus interrupted sutures for repair of episiotomy or second degree tears. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD000947. DOI: 10.1002/14651858.CD000947.pub2

Obstetrics: Normal and Problem Pregnancies. Gabbe, S, Niebyl, J, Simpson, JL. Fifth Edition.

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