Stitches after childbirth: types, treatment, how to deal with complications. How to handle internal and external seams after childbirth

At the birth of a child through natural ways doctors sometimes have to resort to a perineotomy or an episiotomy, which is an incision in the tissue from the vaginal opening back toward the rectum or at an angle to the midline. Stitches on the perineum after childbirth require special attention of physicians and compliance with some recommendations by the young mother.

Read in this article

Why are stitches

Perineotomy is an operation that protects the mother and helps the child to be born. In the second stage of labor, excessive stretching of the tissues of the perineum may occur, there is a threat of its rupture. This happens in such cases:

high crotch;
tissue stiffness in women giving birth for the first time after 30 years;
scars after previous births;
the position of the child during childbirth, when he is facing the perineum with his forehead or face (extensor presentation);
usage obstetric forceps or vacuum extraction of the fetus;
large fruit;
rapid childbirth;
premature eruption of the head with improper delivery by a midwife.

A straight-edged incision heals better than a tear. Therefore, a dissection of the perineum is performed, followed by suturing after the birth of the child. Wound suturing is performed for its speedy healing.

Precautions in behavior after the incision

The length of tissue dissection is about 2-3 cm; after suturing, the incision heals quickly. To prevent this process from slowing down and becoming more complicated, a young mother should take some precautions:

on the first day after childbirth, you should only lie down;
it is allowed to stand and walk already from the second day, for example, a woman should eat at a special high table, which is in the dining room of the maternity hospital;
you can sit only 3 days after removing the stitches or 2 weeks after childbirth, first on chairs and only then on a soft bed or sofa;
feed the newborn should be lying on the bed;
properly care for the perineum;
avoid constipation;
wear cotton non-tight underwear.

When are stitches removed after childbirth? This usually happens a week or earlier after the baby is born. Thus, a woman should be careful in the first 14 days of the postpartum period.

If the sutures are applied using a bioabsorbable material, then they do not need to be removed. The woman is sent home to usual terms, synthetic threads in the incision area disappear completely after a few weeks. Nodules disappear within 2 weeks after birth.

Proper care of the intimate area and seams

How to handle stitches on the perineum after childbirth? The use of special antiseptic agents is not required. After visiting the toilet, a woman should wash herself with warm boiled water from the perineum to the anus and dry the skin with a clean cloth or paper towel. After washing, it is recommended to lie on the bed for some time without a pad, so that the area of \u200b\u200bthe seams dries well.

It is also necessary to change postpartum pads at least every 2 hours to prevent infection.

When performing these simple tips an incision in the perineum is not dangerous. After it, only a small scar remains. If a cosmetic suture was applied, then traces of it are practically invisible.

Usage medicines suture care is required when healing is slow or complications develop. These drugs must be prescribed by a doctor. Treatment with chlorhexidine, hydrogen peroxide is usually used, ointments are less often recommended - Levomekol, Vishnevsky Ointment, Solcoseryl, products with panthenol.

Recovery Exercises

To speed up tissue repair, you can perform special exercises. It should be remembered that before the removal of the stitches, it is impossible to carry out exercises with abduction (breeding) of the legs.

In the first two days, exercises are performed lying in bed. They include bending the legs at the ankle joints, and then at the knees. In the future, raising the pelvis with support on bent legs joins. Useful and breathing exercises. The duration of the lessons is 15 minutes.

In the following days, gymnastics is performed while standing and its duration increases to 20 minutes. Turns and shallow torso bends, standing on toes, light squats are added. Periodic contraction of the sphincter of the anus during the day and attempts to temporarily stop the stream of urine during urination are shown. Such exercises help to restore blood supply to tissues and speed up healing.

Causes of divergence of seams

In some women, however, there is a divergence of the seams after suturing the incision of the perineum. The reason for this is the woman's non-compliance with the recommendations on the regimen:

getting out of bed early;
prolonged sitting during the first week after childbirth;
incorrectly performed exercises during gymnastics.

In addition, the seams diverge when the postoperative wound becomes infected.

Symptoms to watch out for

If a woman has pain in her stitches after giving birth, she should tell her doctor. This is one of the main symptoms of non-healing wounds. In addition, signs of trouble can be:

bleeding from the incision;
a feeling of fullness in the perineum;
tissue swelling;
fever, chills, weakness;
purulent discharge;
formations under the skin in the form of tubercles or cones.

In all these situations, please contact women's consultation. Otherwise, the sutures will hurt for a very long time, and after the wound has healed, the deformation of the walls of the vagina and perineum will remain.

Methods for correcting abnormal skin fusion

The perineum is usually sutured with two rows of sutures: the first is superimposed on the muscles, and the second on the skin. If only the superficial suture has parted, measures are taken to prevent infection (treatment with chlorhexidine, hydrogen peroxide, brilliant green and other antiseptics), re-suturing is not carried out.

If a woman really has the whole seam open, then purulent inflammation usually becomes the cause. In this case, there is severe pain, fever, purulent discharge. In this case, you should immediately consult a doctor, you may need to debridement wounds.

With a significant deformation remaining after a parted deep seam, it is further shown.

So, stitches on the perineum after childbirth are superimposed for the speedy healing of the tissue incision. Subject to the rules of care and careful attitude of a woman to her health, her well-being quickly returns to normal. If disturbing symptoms appear, you should seek help from a gynecologist.

How long do they heal
How to care for stitches
What complications can be
How to shoot

During childbirth, it is not uncommon for a woman to have a rupture of the vagina, uterus, or perineum. This situation is not difficult, because doctors skillfully and quickly sew up such gaps, without focusing on this special attention.

In fact, all this is very unpleasant. First, the sewing process is enough painful procedure. Secondly, stitches after childbirth can bring a lot of worries and troubles to a young mother. You need to know how to minimize and reduce them undesirable consequences no breaks. Proper postpartum care for these "battle" scars will largely depend on where they are located.

Kinds

Depending on where exactly the rupture occurred, there are external (on the perineum) and internal seams after childbirth (on the cervix, in the vagina). They are made with threads from different materials, which means they require special care, which the young mother must be informed about.

Stitches on the cervix

reason: large fruit;
anesthesia: not performed, since the cervix loses sensitivity for some time after childbirth;
suture materials: catgut, which allows you to apply self-absorbable sutures that do not have to be removed later; as well as vicryl, caproag, PGA;
advantages: do not cause inconvenience, are not felt, do not cause complications;
care: not required.

Stitches in the vagina

reason: birth trauma, vaginal ruptures of various depths;
anesthesia: local anesthesia using novocaine or lidocaine;
suture material: catgut;
disadvantages: preservation of soreness for several days;
care: not required.

Seams at the crotch

causes: natural (damage to the perineum during childbirth), artificial (dissection by a gynecologist);
types: I degree (the wound affects only the skin), II degree (skin and muscle fibers), III degree (rupture reaches the walls of the rectum);
anesthesia: local anesthesia with lidocaine;
suture materials: catgut (at I degree), non-absorbable threads - silk or nylon (at II, III degree);
disadvantages: preservation of soreness for a long time;
care: rest, hygiene, regular treatment with antiseptic solutions.

A particular problem is the external seams after childbirth, which are performed on the perineum. They can cause various kinds of complications (suppuration, inflammation, infection, etc.), therefore, they require special, regular care. A young mother should be warned about this even in the maternity hospital, and also informed about how to treat such wound surfaces. Usually women have many questions about this, and each of them is very important for her health and condition.

How long does it take for stitches to heal after childbirth?

Every woman who could not avoid ruptures is concerned about how long the stitches heal after childbirth, because she really wants to quickly get rid of pain and return to her previous lifestyle. The speed of healing depends on many factors:

when using self-absorbable threads, healing occurs within 2 weeks, the scars themselves dissolve for about a month and do not cause much trouble;
much more problematic is the question of how long the sutures heal when using other materials: they are removed only 5-6 days after childbirth, it takes from 2 to 4 weeks for their healing, depending on individual features body and care for them;
the healing period of postpartum scars can increase when microbes enter the wounds, therefore, the ability to treat wound surfaces and monitor their cleanliness is required.

In an effort to quickly return to their old way of life and get rid of painful sensations, young mothers are looking for ways to quickly heal the stitches after childbirth so that they do not interfere with their enjoyment of the joy of communication with the newborn. This will directly depend on how accurate a woman is and whether she competently takes care of her postpartum “combat” wounds.

How to care for seams?

If ruptures could not be avoided, you need to know in advance how to care for the stitches after childbirth in order to avoid complications and speed up their healing. The doctor must definitely give detailed advice and tell you how to do it correctly. This is part of his professional duties, so feel free to ask. Usually, caring for stitches after childbirth involves a sedentary lifestyle, hygiene, and treatment with various wound healing and antiseptic agents.

In the maternity hospital, the midwife treats the external scars with “greenery” or a concentrated solution of “potassium permanganate” 2 times a day.
Change your pad every two hours after giving birth.
Use only loose natural (preferably cotton) underwear or special disposable panties.
Do not wear tight fitting underwear that strong pressure on the perineum, which has a bad effect on blood circulation: in this case, the healing of the sutures after childbirth can be delayed.
Wash your face every two hours and after every visit to the toilet.
Go to the toilet with such frequency that it is filled bladder did not interfere with uterine contractions.
In the morning and evening, when you take a shower, wash your perineum with soap and water, and during the day just wash it with water.
It is necessary to wash the outer scar as carefully as possible: direct a jet of water directly at it.
After washing, dry the perineum with blotting movements of the towel in one direction - from front to back.
Another important question is how long it is impossible to sit with stitches after childbirth if they are made on the perineum. Doctors, depending on the degree of damage, call the period from 7 to 14 days. At the same time, it is allowed to sit on the toilet immediately on the first day. After a week, you can squat on the buttock opposite the side in which the damage was recorded. It is recommended to sit down exclusively on a hard surface. This issue needs to be considered during the return of a young mother home from the hospital. It is better for her to lie or half-sitting in the back seat of the car.
No need to be afraid of severe pain and because of this, skip a bowel movement. This creates an additional load on the muscles of the perineum, as a result of which the pain intensifies. To make this process easier, you can safely use glycerin suppositories after childbirth with stitches: they are rectal and soften the stool without harming the wounded perineum.
Avoid constipation, do not eat products that have a fixing effect. Before eating, drink a tablespoon of vegetable oil so that the stool normalizes and does not slow down the healing process.
Do not lift weights weighing more than 3 kg.

These are the basic rules of hygiene that allow, even with breaks, the body of a young mother to quickly recover and return to normal. But what to do if the stitches after childbirth hurt for too long, when all the deadlines have already passed, but it still doesn’t get easier? Perhaps some factors provoked complications that will require not only additional care but also treatment.

What complications can occur with suturing?

Very often, a woman continues to feel pain and discomfort after two weeks after giving birth. This is a signal that something has prevented healing, and this is fraught with various complications - in this case, medical intervention, treatment, and treatment of sutures after childbirth with special preparations will be required. Therefore, a young mother should be extremely attentive and sensitive to her own feelings, monitor the healing process of postpartum injuries very carefully.

if the scars do not heal for a very long time, they hurt, but during a medical examination no pathologies and special problems were identified, the doctor may advise warming up;
they are carried out no earlier than 2 weeks after childbirth to allow the uterus to contract (read more about the restoration of the uterus after childbirth);
for this procedure, use "blue", quartz or infrared lamps;
heating is carried out for 5-10 minutes from a distance of 50 cm;
it can be done independently at home after consulting a doctor;
ointment for healing sutures "Kontraktubeks" can also relieve pain: it is applied 2 times a day for 2-3 weeks.

The seam has come apart:

if the seam has opened after childbirth, it is strictly forbidden to do something at home;
in this case, you need to call a doctor or an ambulance;
if the divergence of the sutures after childbirth was indeed diagnosed, most often they are superimposed anew;
but if at the same time the wound has already healed, this will not require any medical intervention;
in such cases, the doctor, after the examination, will prescribe how to treat the stitches after childbirth: usually this wound healing ointments or candles.

very often women complain that their stitches itch after childbirth, and very strongly - as a rule, this does not indicate any abnormalities and pathologies;
itching is most often a symptom of healing, so it should not cause anxiety in a woman;
in order to somehow alleviate this unpleasant, albeit favorable symptom, it is recommended to wash yourself more often with water at room temperature (the main thing is not to be hot);
this also applies to those cases when the suture is pulled: this is how they heal; but in this case, check for yourself whether you started sitting up too early and whether you have to carry weights.

if a woman notices an unpleasant, abnormal discharge (not to be confused with the restoration of menstruation), smells bad and is suspicious brownish-green in color, this may mean festering, which is a serious health hazard;
if the seam is festering, you must definitely tell the doctor about it;
this is how complications such as inflammation of the sutures after giving birth or their divergence can occur - both cases require medical intervention;
if infection occurs, antibiotics may be prescribed;
from external processing, it is recommended to smear with Malavit shvygel, Levomekol, Solcoseryl, Vishnevsky ointments;
if the scars fester, only a doctor can prescribe what can be treated: in addition to the above-mentioned anti-inflammatory and wound-healing gels and ointments, chlorhexidine and hydrogen peroxide are also used, which disinfect wound cavities.

if, after childbirth, shovkrovit, most likely, the basic rule was violated - do not sit during the first weeks: the tissues are stretched, and the wound surfaces are exposed;
in this case, it is not recommended to treat the problem area on your own, but to contact a specialist directly;
alteration may be required;
but most often it is enough to use wound-healing ointments and gels (Solcoseryl, for example).

If the first days passed without the complications and special difficulties described above, there will be one more procedure - the removal of sutures after childbirth, which is performed by a specialist in outpatient settings. You also need to mentally prepare for it, so as not to panic and not be afraid.

How are stitches removed?

Before discharge, the doctor usually warns on which day the stitches are removed after childbirth: normal flow the healing process, this occurs 5-6 days after their application. If the woman’s stay in the maternity hospital is delayed, and she is still in the hospital at that moment, this procedure will be performed on her there. If the discharge happened earlier, you will have to come again.

And yet, the main question that worries all women going for this procedure is whether it hurts to remove stitches after childbirth and whether any anesthesia is used. Of course, the doctor always reassures that this procedure just like a mosquito bite. However, everything will depend on the pain threshold of a woman, which is different for everyone. If there were no complications, there will actually be no pain: only an unusual tingling sensation mixed with a burning sensation is felt. Accordingly, anesthesia is not required.

Childbirth is an unpredictable process, so anything can happen. At the same time, ruptures are not uncommon and are not perceived by doctors as a complication or difficulty. Modern medicine involves professional, competent suturing after childbirth, which subsequently deliver a minimum of discomfort with proper care.

During childbirth, a woman receives many microtraumas that heal on their own within a few weeks. They do not cause discomfort to a young mother and do not require specific treatment.

Severe perineal and cervical tears often occur, leading to sutures that, when improper care may cause complications.

Why are stitches needed?

Stitches after childbirth are superimposed in the event that ruptures occur during the advancement of the child through the birth canal. Despite the elasticity of the cervix and vaginal walls, it is quite difficult to avoid injuries. Most often, ruptures occur with a large fetus, rapid delivery, when the tissues are not stretched enough, with the wrong behavior of the woman in labor. The last point concerns women who start pushing ahead of time or strain the small pelvis, creating an obstacle to the passage of the child.

Stitches are also applied in case of dissection of the perineum (episiotomy). The reasons are similar - the position of the fetus is incorrect, its large size, poor muscle elasticity. The dissection of the perineum is also necessary for prolonged labor, when the waters have broken, and the child is difficult to pass through the birth canal. In these cases, episiotomy saves the fetus and woman from lacerations, which heal much longer than a surgical incision. More about amniotomy →

Types of seams

There are two types of postpartum sutures:

Internal - superimposed on the walls of the vagina and cervix with mechanical injuries. Internal seams after childbirth heal quickly enough and consist of a bioabsorbable material. When applied, anesthesia is not required, since the neck has no sensitivity.
External - superimposed during dissection or rupture of the perineum. Depending on the wound, both a self-absorbable material and a conventional one used in surgery and required to be removed on the fifth day can be used.

How long do stitches heal?

If a woman follows all the instructions prescribed by the doctor, then the postpartum sutures heal within 3-5 weeks. With large gaps and non-observance of elementary hygiene rules, the healing process can drag on for several months.

The bioresorbable material completely disappears from the wound around the second week after delivery. Ordinary surgical threads are removed on the 5th day after childbirth.

Feelings of a woman

Unfortunately, suturing almost always leaves an unpleasant imprint. It is impossible to avoid pain and discomfort, but subject to several important rules, which will be discussed later, can reduce the healing time of the sutures.

The first few days in inguinal region there may be a burning sensation, itching or swelling. If there is no bleeding, then there is no cause for concern. The main thing is not to expose your body heavy load and if the pain is severe, be sure to see a doctor.

There may be discomfort during intercourse. Until the stitches are completely healed, you must give up sex! A woman will not only be hurt, but a complication is possible.

How to care for wounds?

If internal seams after childbirth do not require special care, then external wounds must be monitored with special care. The first treatment is carried out in the hospital, then repeated 2-3 times a day. Usually, green or potassium permanganate is used for this.

After being discharged for sutures, a woman needs to process the sutures on her own and follow a few simple rules:

Change the gasket every 2-3 hours, at least. Postpartum discharge disturbs every woman in labor, so the use hygiene products necessarily. If possible, it is better to use special pads that have a natural base and a soft, non-synthetic material as a cover. They prevent the appearance of allergies, irritation and promote rapid healing of sutures.
Rinse with warm running water, after a shower, walk a little without underwear. In the air, the seams after childbirth heal much faster. You can not wipe the perineum with a towel after a shower. It is better to lightly blot with a cotton cloth or wait until it dries completely.
After a shower, treat the seams with brilliant green.
You can not lift weights for a month and sit for at least 10 days.
You need to wear underwear only from natural materials, even better - disposable cotton panties. At first, it is necessary to abandon tight underwear that disrupts blood flow in the genitals.

Possible Complications

In most cases, the stitches heal well after childbirth, without causing the woman unnecessary discomfort. But there are several diseases that can be caused by poor hygiene and weakened immunity of a young mother:

The seam came apart. With improper suturing, bowel movements with effort and heavy lifting, the sutures may diverge. Most often this happens within the first three days after childbirth, but maybe later. Treatment consists of re-suturing.
The seam festered. If a woman has an infection that has not been cured before childbirth or she does not observe hygiene, then suppuration of the suture is possible. In this case, severe pain occurs, the wound swells, pus is released from it. Treatment can only be prescribed by a doctor, you should not try to get rid of inflammation on your own!
The stitches hurt a lot. As mentioned above, at first the outer seams cause pain. Within the normal range, when a woman feels discomfort when sitting or washing. If the pain does not stop, but intensifies, there is a burning sensation or pressure when walking, then we can talk about the inflammatory process. You can’t start the disease, you need to see a gynecologist and get recommendations for treatment.

No need to be afraid of suturing during childbirth. This is customary in modern medicine manipulation that allows you to save the health and life of the child, and the woman to prevent the appearance of ugly, unaesthetic wounds.

Useful video about perineal plastic surgery

During childbirth, a woman receives many microtraumas that do not cause discomfort and heal on their own within a few weeks. But more serious injuries are not uncommon. For example, hemorrhoids or ruptures of the cervix and perineum. Sometimes doctors have to sew up torn tissue. Stitches after childbirth require mandatory care. Otherwise, it can lead to serious problems.

Internal seams

Internal stitches are called, which are superimposed on the cervix or vaginal walls during birth injuries. When stitching these tissues, anesthesia is not used, since the cervix has no sensitivity - there is nothing to anesthetize there. Access to the internal genital organs of a woman is difficult, so the sutures are applied with a self-absorbable thread.

To prevent complications, you should follow the rules of personal hygiene. These include the following activities:

Regular change of sanitary napkins.
Wearing comfortable underwear that has a loose fit and is made from natural materials. The best option would be special disposable panties. This also applies to towels.
Regular hygiene of the genitals with warm water and baby soap. You can use infusions of medicinal herbs, such as chamomile or calendula. It is important to wash yourself after every visit to the toilet.

Internal seams do not require processing. After their imposition, it is only obligatory for a woman to observe the rules of personal hygiene. It is recommended to refrain from sex for 2 months, not to lift heavy objects during this time, to avoid problems with bowel movements. The latter include delayed defecation, constipation, and hard stools. It is useful to take a spoonful of sunflower oil before meals. Usually, a cleansing enema is done before childbirth, so the stool appears on the 3rd day.

The reasons for the rupture of the cervix and the subsequent suturing, as a rule, is the incorrect behavior of the woman during the birth process. That is, when the woman in labor is pushing, and the cervix has not yet opened, the baby's head presses on it, which contributes to the rupture. Often, subsequent suturing after childbirth is facilitated by: an operation on the cervix in the woman's history, a decrease in its elasticity, or childbirth in adulthood.

External seams

External seams are superimposed when the perineum is ruptured or dissected, and those that remain after a caesarean section can also be included here. Depending on the nature of the wound, doctors use both a self-absorbable suture material and one that requires removal after a while. Behind the outer seams permanent care, the absence of which can lead to complications.

While you are in maternity hospital, external seams left after childbirth are processed by a procedural nurse. To do this, use a solution of brilliant green or potassium permanganate. After discharge, you will have to deal with daily processing on your own, but you can do it in the antenatal clinic. If non-absorbable threads were used, they will be removed within 3-5 days. As a rule, if there are no problems, this is done before discharge from the hospital.

Precautions to take when caring for external seams:

Can't be accepted sitting position You can only lie or stand.
You can't scratch.
Do not wear underwear that will put pressure on the crotch. Loose panties made of natural materials or special disposable underwear are not bad.
Do not lift weights for 1-3 months.
On the first day after childbirth, defecation should be delayed.
For 2 months after giving birth, you should not have sex.

The hygiene rules are the same as for the care of internal seams. To them, you can add the use of special gaskets that have a natural base and coating. They will not cause irritation and allergies, and will promote rapid healing. After a shower, it is advisable to walk a little without clothes. When air enters, postpartum sutures will heal much faster.

Reasons for making an incision in the perineum during childbirth:

Threat of rupture of the perineum. Incisions tend to heal faster and cause less inconvenience and negative consequences.
Inelastic tissues of the vagina.
The presence of scars.
Inability to push for medical reasons.
Incorrect position of the child or its large size.
Rapid childbirth.

How long do postpartum sutures take to heal and is it painful to remove them?

Many women in labor are interested in the question - how long after childbirth the stitches heal. The healing time depends on many factors. These include medical indications, suture technique, materials used. Postpartum sutures are produced using:

Bioabsorbable material
Non-absorbable
metal brackets

When using absorbable material, healing of the damage takes 1-2 weeks. The stitches themselves dissolve after childbirth for about a month. When using brackets or non-absorbable threads, they are removed 3-7 days after childbirth. Complete healing will take from 2 weeks to a month, depending on the cause of the tears and the size. Large - can heal for several months.

Discomfort at the site of the suture will be felt for about 6 weeks. The first time may be painful. The suture applied after childbirth hurts, just like any surgical one. This usually goes away within 10 days. Suture removal is a virtually painless procedure that should not be feared.

How to handle stitches after childbirth?

The treatment of sutures after discharge from the hospital is carried out either independently or in the antenatal clinic. Hospitals use brilliant green or potassium permanganate. How to smear the seams at home, the doctor will explain. Ointments are usually recommended: solcoseryl, chlorhexidine, levomekol. Hydrogen peroxide can also be used. With proper care and proper processing, the sutures heal quickly, without negative consequences and pronounced cosmetic effects.

How long can you sit?

The minimum period during which you can not take a sitting position is at least 7-10 days. A longer time limit is also possible. This does not include sitting on the toilet while going to the toilet. You can sit on the toilet and walk from the first day after suturing.

What are the complications of sutures

If the stitches are not properly cared for and precautions are not taken during the healing period, complications can occur. This suppuration, divergence and pain at their locations. Let's consider each type of complications in order:

Suppuration. In this case, there are strong pain sensations, there is swelling of the wound, purulent discharge. Body temperature may rise. This outcome is manifested by insufficient attention to personal hygiene or an infection that was not cured before delivery. If you suspect that the stitches are festering, you should immediately consult a doctor who will prescribe the correct treatment.
Pain. This does not apply to painful sensations that occur in the first days after suturing. Pain often indicates an infection, inflammation, or some other problem, so it's best to see a doctor. It is undesirable to self-medicate, only a doctor can prescribe you necessary procedures and medicines.
Discrepancy. This rarely happens with internal seams, more often they diverge if located at the crotch. The reasons for this may be early sexual activity after childbirth, infection, too early sitting down and sudden movements. When the seams diverge, the woman is disturbed severe pain, there is swelling of the wound, which sometimes bleeds. Sometimes the temperature rises, which indicates infection. A feeling of heaviness and fullness indicates the presence of a hematoma.

Video: Seam for caesarean section

After watching the speech of the obstetrician-gynecologist Alexander Viktorovich Kurgansky below, you will receive answers to the main questions regarding stitches after a caesarean section.

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What you will learn from the postpartum suture article:

1
Types of postpartum sutures;
2
How many stitches heal after childbirth;
3
Features of caring for seams on the perineum;
4
How to care for a suture after a caesarean section;
5
Features of the mode with seams on the perineum;
6
How long can you not sit down with stitches on the perineum;
7
In what position to feed the child with stitches on the perineum;
8
Features of the regimen for stitches after caesarean section;
9
How long do stitches bother after childbirth;
10
Possible complications of postpartum sutures.

To begin with, let's figure out what seams are, since each type of seam may require its own restrictive measures and care features.

So, after childbirth are possible the following types seams:

seam after caesarean section- a transverse incision is also being made in the lower abdomen, which corresponds to lower segment uterus, 12-13 cm long and contains 2 sutures: the inner one - the uterus is sutured, and the outer one, which we see on the skin.
stitches on the cervix- these are internal seams that are superimposed in case of its rupture during physiological childbirth. The reason for this may be incomplete disclosure of the cervix, rapid delivery.
stitches in the walls of the vagina- internal sutures that are applied when the vagina is torn, which also occurs during rapid labor and inflammation of the vagina - while the walls become inelastic and are easily injured.
perineal sutures - external. Superimposed with a rupture of the perineum varying degrees and with episiotomy (artificial dissection of the perineum). The cause of rupture and episiotomy is rapid delivery, high standing of the perineum, breech presentation of the fetus, and others.

Regardless of localization, the seams can be divided into internal and external. No care is required for the internal ones, they are performed with absorbable threads and heal on their own.

External seams differ only in the suture material with which they are performed, and regardless of the location of the seam and the technique for its implementation, they require proper care.

How long do stitches heal after childbirth?

The rate of suture healing depends on several factors. From whether a lacerated wound or cut. From sutures that may or may not be absorbable (threads that require removal or metal staples). From some concomitant diseases which impair the healing of any wounds. And also from the care of the seam and personal hygiene.

Seams on lacerations always heal a week longer than incised ones. Postpartum sutures with the application of absorbable materials heal in about 10-15 days, and dissolve after another week. Sutures using threads that require subsequent removal heal after 15-20 days, and dissolve a week after healing. Stitches, for which metal staples are used, heal in 3-4 weeks and dissolve within 1 week.

The following can worsen the healing of sutures: concomitant diabetes mellitus, massive blood loss, anemia, flabby muscles and skin etc.

How to care for a postpartum suture?

Internal seams do not demand specific leaving. The internal seam after caesarean section is covered with skin and does not come into contact with environment.

And with stitches on the cervix and vagina, it is necessary to empty the bladder, intestines in a timely manner, observe intimate hygiene and don't lift weights. These sutures in most cases are superimposed with absorbable threads and do not require removal, but heal and scar on their own.

External seams are in contact with the environment, therefore there is a risk of infection, and such seams require careful maintenance.

For the first few days, while the woman is in the hospital, the medical staff takes care of the suture after a cesarean section. The seam is treated daily with an antiseptic and a sterile bandage is applied. On average, the stitches are removed after a week, after which the treatment is continued until complete healing.

The seams on the perineum are very disturbing for a woman. These stitches cannot be applied. aseptic bandage, these seams make themselves felt with any emptying and require very careful care. After each urination and defecation, it is necessary to wash with running water at room temperature without soap.

Twice a day, morning and evening, wash the seam with soap, but do not rub them with a washcloth. Then dry the skin in the seam area with blotting movements. It is best to use disposable paper towels for this. But you can get a towel only for the crotch, and change it every day. After water procedures do not rush to put on underwear, air baths promote tissue regeneration.

Do not wear synthetic underwear - only cotton, or good option is a special disposable underwear.

You can not wear tight underwear, it disrupts the full blood flow, which is necessary for the healing of the seam.

It is necessary to change the gasket at least once every 2 hours, even if it is not filled, it is just that microorganisms multiply in it.

These sutures do not need to be treated with antiseptics and antibiotic ointments without indications, they are used only for suppuration of the suture. For care, you can use products that promote the fastest regeneration tissues, but not containing an antiseptic or antibacterial component: bepanten, sea buckthorn oil, etc. In case of suppuration, the seam is treated with antiseptics (brilliant green solution, chlorophyllipt, chlorhexidine, etc.) and antibiotic ointments (levomekol, oflokain, etc.). But with infection and inflammation of the seam, an examination by a doctor is necessary, since inadequate treatment can lead to complications in the form of inflammation of the internal genital organs.

If a dense, inelastic scar is formed, then the doctor may prescribe special absorbable ointments that are applied daily to the scar area for several months.

Features of the mode when postpartum stitches

Most of all, we are afraid of the divergence of the seam. Therefore, with postpartum sutures, precautions must be taken to prevent their divergence. Two components play a leading role here: timely bowel movements and constipation prevention and limitation of physical activity.

Constipation leads to the need to strain during bowel movements, and this is the risk of divergence of the sutures. Also, constipation leads to the reproduction of saprophytic flora, which increases the risk of infection of the seam.

The chair must be tried as much as possible to regulate the diet, but with the need to adhere strict diet this is not always possible. To soften the stool, a nursing woman can daily eat at least a glass of any fermented milk product(yogurt, kefir, fermented baked milk, acidophilus, etc.), milk thistle fiber 1 tsp. up to three times a day with meals and drink plenty of fluids. In the first three days, you can do an enema or put glycerin suppository at every urge to defecate. If constipation still occurs, then it is imperative to do an enema to empty the intestines.

A woman should not lift weights for two weeks. Also with stitches on the perineum, the most important restriction is the prohibition of sitting for at least 2 weeks. And this is perhaps the most difficult moment. It would be easier if the woman after childbirth did not have to take care of the newborn baby and the family. And from the hospital you have to somehow get home. In the car, it is recommended to ride lying, standing or reclining on a healthy side. From a lying position to a standing position, it is necessary to rise, bypassing the seat. It is necessary to get up through the position on the side through the healthy side (opposite from the one on which there are seams), then get on all fours and thus go down to the floor.

You can sit on the toilet a little, but make the main support on the healthy side.

You can not squat and make any sudden movements. All movements should be soft and smooth.
You can start sitting down after two weeks, if there are no concomitant diseases that impair tissue regeneration, and only on a hard surface. And only a week later - on the soft.

If a woman gave birth through a cesarean section, then the first 2-3 days, as a rule, analgesics are administered to reduce the intensity of pain in the area of the postpartum suture, and then it is recommended to wear a special bandage or tighten the stomach with a diaper or, even better, with a long elastic bandage.

After any abdominal operations surgeons do not recommend lifting weights of more than 2 kg. It would be ideal to follow this recommendation for the puerperal. But this can only be done with outside help if the care of the baby is completely taken over by someone close to him, and his mother will be brought only for feeding. And so on until the seam heals - an average of 2 weeks. If this is not possible, then in this case it is recommended not to lift anything more than the weight of the child (3-4 kg).

In what position to feed a child with stitches on the perineum?

It is also necessary to feed the baby lying down. A very comfortable position in which the mother lies on her side, and on this side she puts her hand behind the back of the baby or behind her head. And the baby is on the other side facing his mother, pressing his tummy to her tummy. In this case, you need to put a comfortable pillow under your head. You may also need a pillow or cushion of any fabric under the back in the pelvic area or between the knees.

After 1.5-2 weeks after childbirth, you can feed the baby in your arms reclining, but very carefully.

How long do stitches after childbirth bother?

Stitches can disturb even months after healing. And the intensity of pain decreases by 5-7 days with successful healing. But if the pain is longer, or intensified, if suppuration of the suture is noted, bleeding from the suture, the temperature rises, then this is a mandatory reason to consult a gynecologist.
After 2-3 weeks, itching and a slight feeling of constriction may be noted, which indicates the resorption of the suture.

With stitches on the perineum, discomfort, a feeling of tightness and pain during intercourse are possible for several months to six months.

Within two weeks, pain in the area of the sutures should stop, but sometimes it happens that after this time the sutures continue to disturb the woman, accompanied by pain, discomfort, bloody discharge, bad smell, suppuration, or divergence of the seam. And any of these conditions is a reason to see a doctor.

Possible complications of postpartum sutures:

Pain. If after two weeks the pain persists, and no symptoms are found during a medical examination objective reasons pain, then in this case, heating can be prescribed using an infrared, blue or quartz lamp. The session lasts for 5-10 minutes from a distance of 50 cm. Warming up can be started no earlier than two weeks after birth. If procedures are started earlier, this may cause uterine bleeding. Warming up can be carried out independently at home, but only with the appointment of a doctor after an examination.
They may also be assigned special ointments for resorption of scars.
seam divergence. If the seam has parted, then two options for further tactics are possible. It depends on whether the wound has already healed or not and on the degree of divergence of the seam. In most cases, stitches are not re-applied, and healing occurs secondary tension. This creates a less elastic scar. In some cases, new sutures are applied, but a new skin section must be made, since the sutures do not creep into infected wounds. After that, the local use of drugs that promote the fastest regeneration is recommended.
Itching. In most cases, about two weeks after the suture, the woman begins to itch, sometimes very severe. But, as a rule, this is not a deviation, but, on the contrary, indicates the healing of the suture. Itching is accompanied by resorption of the scar. In this case, it is recommended to wash as often as possible. cool water but not hot!
But in some cases, if itching is present not only in the area of the scar, but also in the area of all external genital organs and in the vagina, this indicates inflammation or dysbiosis of the vagina.
Suppuration. If purulent discharge from the suture is noted, which can be from gray to green in color, with an unpleasant odor, then this condition is very dangerous for the spread of the purulent process and requires a mandatory examination by a doctor. In most cases, external treatment with antiseptics and antibiotic ointments is sufficient, which the doctor should prescribe after the examination. In more severe cases or with concomitant diabetes mellitus, diseases thyroid gland systemic antibiotics may be prescribed.
Bleeding. If there is bleeding from the postpartum suture, this indicates its failure, that there are areas where the edges of the wound do not close and, exposed during movements, bleed. This occurs when the seam diverges after early sitting. In most cases this does not require special measures, and the seams grow together on their own. In some cases, repeated suturing is required.

When do gaps appear and why? How to avoid pain in postpartum period and how to return to normal life?

Before talking about internal seams every woman needs to know anatomy of internal female organs , which are involved in the process of childbirth, where, in fact, a gap can occur.

The uterus, cervix, vagina, perineum are involved in childbirth. If the birth goes well, must not be. This is a formidable complication, such cases are very rare, during childbirth the doctor may notice signs of a threatening rupture and do it in time.

Perineal tear refers to external tears, and the tactics of conducting external after childbirth is different, since suturing perineal tears refers to sutures that are sewn with non-absorbable material (silk, polypropylene) and then removed.

Basically we'll talk about ruptures of the cervix and vaginal walls. It is these gaps that are sutured with internal sutures, which are then not removed, but dissolve on their own.

Causes of internal ruptures

The most common causes of internal ruptures include:

large fruit;
tissue inelasticity;
fast or rapid childbirth;
narrow vagina;
inflammatory diseases of the vagina during pregnancy;
childbirth after abortion.

Physiology normal delivery involves prolonged dilatation of the cervix, within 12 hours or more especially in primiparas. In those women who give birth again, as a rule, the opening of the cervix occurs faster.

Therefore, in the first stage of labor, when preparation is underway birth canal and disclosure of the cervix, supervision by a doctor is necessary.

If the cervix is not fully dilated and the woman pushes prematurely, the cervix may rupture. The task of the doctor, if he sees premature attempts, is to “keep” the woman from this wrong step. For the same reason, the walls of the vagina are also torn.

Internal breaks cannot be seen immediately after delivery, for this, the doctor, after separating the placenta, examines the cervix and vagina in the mirrors.

The procedure is painless, but necessary so that even small cracks are sutured and do not cause trouble. Any unsutured wound can become inflamed after childbirth.

Procedure for suturing a rupture of the cervix painless. So nature protected the woman after childbirth from discomfort. When suturing the walls of the vagina, pain may occur, because the vagina is rich in nerve endings. In this case, the doctor anesthetizes the injured vaginal walls with novocaine or lidocaine.

Catgut- the most commonly used suture material for internal seams. These are natural threads made from sheep intestines. In its structure, it is similar to human tissues, and therefore after 7-10 days it can resolve itself, this occurs under the action of the enzymes of the woman's body.

Can be used for suturing semi-synthetic yarns such as vicryl, PGA, caproag, which resolve somewhat longer, within 30-60 days.

Seam care

As such, there is no suture care, but a woman needs to know that in the postpartum period, discharge will be released from the uterus for several weeks - lochia, which make it difficult to create sterile conditions in the area of suturing. It is also not possible to apply a sterile bandage.

The tactics of conducting a puerperal in the postpartum period has changed. If a before a woman, which has internal seams, was allowed to get up after childbirth in a few days and brought the baby to feed on the third day, now the situation is different.

Today, the management of women in the postpartum period with sutures is almost no different from healthy women. The joint stay of a woman and a child immediately after childbirth implies the active behavior of the puerperal.

If there are stitches, then you need to stay in the supine position for at least 2-3 days, so some help from medical personnel may be required.

So precautions must be taken so that the seams do not separate (especially deep ones) and do not fester. Sitting, as usual, is also not recommended, it is advisable to sit reclining, or sit down on one of the buttocks. Such a precautionary measure is necessary for a month or a little more.

Can't start before after two months. This makes it possible for the torn walls to grow together well and resume their elasticity.

If a woman starts to lead sexual life before this time, a situation may arise when infection of completely unhealed tissues occurs with all the ensuing consequences.

The child should be fed only in the supine position, and take food herself in a standing or lying position. It is advisable not to lift weights during this period, as this can provoke a divergence of the internal seams. It’s not even worth lifting a child, especially if you have a large baby.

The main condition for self-care for internal seams remains personal sanitation and hygiene. Until the tissues are completely healed, Take a shower 1-2 times a day, in any case not a bath!

Need to use spacers, immediately after childbirth with special postpartum, and then daily, which need to be changed more often to ensure dryness of the wounds.

Slimming underwear women who have internal seams, too it is contraindicated to wear one and a half to two months. The fact is that such underwear creates excessive pressure on the perineum and the walls of the vagina, and it, in turn, interferes with the rapid healing of the sutures.

Tactics of behavior after childbirth

It must be understood that the usual rhythm of nutrition for a woman after childbirth is not suitable.

Due to the fact that all intracellular water rushes into the mammary glands, the body's work is being restructured, in the first days after childbirth, puerperas may occur. Therefore, even women who do not have stitches, prescribe a diet: more fluids, broths, less bread, and so on.

All this needs to be known and remembered by a woman who has stitches. unwanted constipation may create stress on seams that may come apart.

If you see that there is no stool for 1-2 days, take a laxative or take an enema. Immediately after emptying, you need to wash the external genitalia with warm water and an antiseptic solution, because the lower edge of the vaginal wall, where there may be stitches, is in contact with the perineum.

If a internal breaks were deep and multiple, the doctor may prescribe antibiotics in the early postpartum period, this is done to prevent complications. Complications can occur in the postpartum period, in which case you should immediately consult a doctor.

In which case it is impossible to postpone a visit to the gynecologist?

if there is pain inside the vagina that does not go away;
there was heaviness in the lower abdomen and growing pains;
a sudden high fever;
purulent discharge appeared from the vagina.

Sometimes there may be another cause for these symptoms, but if you've had internal stitches, you need to rule out the underlying problem! All these symptoms, to one degree or another, indicate either inflammation of the sutures, or their divergence. The doctor should prescribe you treatment, which can be either local, with stitches, or general.

But you need to know: even if you do not have any complaints, you still need to contact the antenatal clinic. Immediately after childbirth, it is difficult to assess the condition of the sutures in cosmetic terms, because there is swelling of the tissues.

The doctor should examine the internal seams, and Special attention pay attention to the condition of the cervix. If the sutures on the neck have grown together incorrectly, this can lead to complications in the future.

First of all, a rough scar that has formed can lead to because the cervix must be tightly closed during pregnancy.

And secondly, a rough scar during childbirth may prevent the cervix from opening completely, which can also lead to sad consequences. Therefore, only an examination on the gynecological chair a month after the birth will allow you not to worry about your future or make a decision - to excise the old scar and apply new sutures.

Tears are among the most common injuries that occur during childbirth. They occur at the stage of expulsion of the fetus from the uterus. Perineal tear is one of the most common injuries of this type. It is mainly associated with insufficient elasticity of the tissues of the organ.

Causes of perineal tissue trauma during childbirth

The perineum is a collection of pelvic floor muscles between the anus and the posterior wall of the vagina. It consists of the anterior (genitourinary) and anal regions. During childbirth, when the fetus passes through the birth canal, the soft tissues of the perineum are stretched. If the elasticity is insufficient, a gap is inevitable. The frequency of pathology is approximately 1/3 of the total number of births.

Predisposing factors include:

the first childbirth after the age of 35, when there is a natural decrease in muscle elasticity;
incorrect behavior of the woman in labor - especially characteristic of inexperienced primiparous women who tend to panic and not follow the commands of the doctor and obstetrician;
untimely or incorrectly provided medical care;
the use of obstetric forceps or vacuum extraction;
rapid delivery - pressure on soft tissues increases significantly;
inflammatory processes in the genitals, leading to thinning and decrease in muscle elasticity;
scars left after previous injuries or surgical procedures;
weakness labor activity, prolonged attempts, causing swelling.

The threat of perineal rupture increases with or the birth of a large fetus (more than 4 kg), with childbirth later than 42 weeks of gestation (post-term baby).

The classification of birth injuries of the perineum allows us to distinguish the following degrees of severity of ruptures:

1 degree - there is damage to the outer layer of the vagina or a violation of the integrity of the skin;
2 degrees - mark injuries to the muscle layer of the organ;
Grade 3 - traumatized external sphincter up to a complete break;
Grade 4 - occurs in rare cases, injuries of the walls of the rectum are characteristic.

If the posterior wall of the vagina, the muscular layer of the pelvic floor and the skin of the surface are affected, while maintaining the integrity of the anus, a central rupture of the perineum is diagnosed. In this case, the birth of a child occurs through an artificially created channel. This severe injury is extremely rare.

Treatment of injuries should be immediate, as they are fraught with serious consequences. The most dangerous among them is heavy bleeding. Through open wound pathogens can easily enter the body, causing an inflammatory process in the genitals.

More distant negative consequences of a birth injury of the perineum include violations of the microflora of the vagina,. Grade 3 and 4 tears can lead to urinary and fecal incontinence, other disturbances in work urethra and rectum.

Diagnosis of damage is not difficult. Immediately after the end of childbirth (exit of the placenta), the doctor examines the condition of the birth canal, which allows you to determine the presence of ruptures and their severity.

Treatment

After identifying injuries with the help of special vaginal mirrors, they are sutured. It is very important to determine the severity of the damage. A first and second degree perineal tear requires suturing, which is performed under local anesthesia. The integrity of the perineum is restored with catgut sutures, which dissolve on their own over time, or with silk sutures, which must be removed. At the first degree, the seams are applied in one layer, at the second - in two.

Treatment of grade 3 tears involves the use of general anesthesia. The woman in labor is examined not only the muscle layer, but also the anus and rectum. In this case, suturing begins with the restoration of the integrity of the walls of the rectum and sphincter. Then suturing is performed to eliminate damage to the skin. Suturing is carried out immediately or within half an hour after childbirth.

If there are risks of rupture during childbirth, at the birth of a large child and in the case of rapid delivery- shown episiotomy (perineal incision). Thanks to this intervention, the exit from the vagina becomes wider, which prevents damage to the rectum and blood vessels.

Conduction helps not only to avoid injury to the woman in labor, but also stops bleeding and minimizes Negative consequences for a child.

Before making an incision, the genitals are treated with an iodine solution. The dissection is performed with the help of special scissors at the moment when the attempt becomes the most intense. This moment is more favorable for manipulation, because with strong tension, the woman feels less pain. The length of the cut is 20 mm.

Seam care after suturing tears

How long does a perineal tear heal after childbirth and how to properly care for the stitches?

Self-absorbable sutures take two weeks to heal. Usually the process goes well. Seams from other materials will be tightened within a month. The duration of recovery depends on the individual characteristics of the organism and the severity of the ruptures. The patient must know the rules of care and follow medical recommendations that will help her recover as soon as possible.

Rules of conduct after childbirth:

Treat seams regularly with green paint or mortar potassium permanganate(at least 2 times a day). Immediately after childbirth, this is done by the midwife, in the future, the processing is done independently.
Observe the rules of personal hygiene: wash the genitals with warm water as often as possible, change pads every 2-3 hours;
Wear only cotton underwear. It should be free and not exert excessive pressure on the perineum.
When taking a shower, direct the water jet from top to bottom. Do not rub the genitals with a washcloth or hard towel. Dry the skin with gentle blotting movements.
While at home, it is recommended to dry the affected area with air baths, ointments (Solcoseryl, Bepanten), and do special gymnastic exercises.
Do not lift weights above 3 kg, avoid physical activity and doing sports.
Introduce foods into the diet that provide normal bowel movements and eliminate constipation.
The sexual life of the spouses can be resumed no earlier than 1.5-2 months after the complete healing of the injuries.

Separately, it is necessary to highlight the need for regular visits to the toilet. The process of urination and defecation delivers severe pain. Fear of pain and discomfort makes a woman postpone the process to the last. Cluster stool puts even more stress on the muscles of the perineum, which only exacerbates the severity of the situation.

To relieve pain, painkillers and glycerin suppositories can be prescribed to soften the stool. With severe swelling, an ice pack is applied. For third-degree tears, antibiotics are prescribed to prevent infection of the rectum.

During the first 10-14 days after suturing the gaps, it is forbidden to sit. Mom should rest more, not make sudden movements. Eating should be done standing up or lying down using the bedside table. The baby should be fed lying down.

How long can you sit?

You can sit on hard surfaces after two weeks, on soft surfaces after three weeks. When returning from maternity hospital in the car, the patient is advised to take a reclining position to eliminate pressure on the perineum.

Complications

Among frequent complications allocate:

painful sensations;
divergence of seams;
severe itching and swelling;
suppuration;
bloody issues.

To relieve pain and itching, heating of a quartz or infrared lamp, lubrication of the seams with Contractubex ointment. Itching often indicates a healing process, but if it is too bothersome, washing the genitals with cool water is recommended.

Discharge of pus usually indicates the penetration of an infection. In this case, antibiotics, ointments Levomekol, Vishnevsky, Solcoseryl are prescribed. Chlorhexidine and hydrogen peroxide are used to disinfect the wound cavity. The presence of bleeding requires additional suturing of the damaged area.

Most dangerous complication occurs when the seams are torn. In this situation, it is strictly forbidden to self-medicate. The woman should immediately call an ambulance. Usually required re-imposition stitches in a medical facility.

Rupture Prevention

There is a popular belief that it is inevitable. This is not true. You can prevent damage to the perineum through careful preventive preparation during pregnancy. Preventive measures include the implementation of special intimate gymnastics, perineal massage.

Massage

The best prevention is regular massage. It can be done at any time, but still the best period is the third trimester. The benefits of massage are as follows:

activates blood circulation, improves metabolism in tissues;
trains muscle tissues perineum;
gives the muscles the necessary softness, suppleness and elasticity;
promotes relaxation, which significantly reduces the risk of injury.

For maximum effectiveness, perineal massage for the prevention of ruptures is performed using natural oil. You can use linseed, pumpkin, burdock, olive oils. There is also a special oil for perineal massage, which can be purchased at a pharmacy.

Before the massage you need to take a warm shower. The intestines and bladder should be emptied, hands should be washed thoroughly. The perineum, genitals and fingers are lubricated with oil. A woman needs to take a comfortable position and relax as much as possible. With fingers inserted into the vagina, make gentle movements to the side anus by pressing on back wall vagina. Pressing should be alternated with the usual massage movements.

The duration of the massage is 5-7 minutes. Usually it is difficult for a woman to carry out the procedure on her own, because her stomach is in the way, so the help of people close to her is very desirable. A number of contraindications should be taken into account in which massage cannot be performed. In particular, it is inflammatory and infectious diseases genitals. Massage in this case can be carried out only after a complete cure, otherwise it will contribute to the further spread of infection in the body.

Massage is categorically not recommended if there is a threat of miscarriage or if the fetus is in the wrong position and if the pregnant woman has skin diseases. It is very important that the procedure does not cause any negative emotions or physical discomfort. Before performing it, you need to obtain the consent of the doctor who is observing the expectant mother.

Gymnastics

To effective prevention includes the implementation of special gymnastic exercises which help to improve the elasticity of the perineum.

Exercise 1. Become sideways to the back of the chair and rest your hands on it. Take the leg alternately to the side 6-10 times.

Exercise 2. Set your feet wide. Slowly sit down, holding the body in this position for a few seconds, then also slowly rise. Do the exercise 5-6 times.

Exercise 3 Put your feet shoulder width apart. Breathing deeply, alternately draw in the stomach, and then relax its muscles. The back should be straight.

Exercise 4 Alternately strain and relax the muscles of the anus and vagina. The exercise can be done both in the supine position and sitting. This exercise can be performed not only at home, but also at work and even in public transport.

Nutrition

A pregnant woman should also pay attention to her diet. Vitamin E must be included in it. It can be taken both in capsules and drunk vegetable oil which is rich in these vitamins. The menu should include fish that is rich fatty acids or fish fat. From 28-30 weeks it is recommended to take a dessert spoon apple cider vinegar before breakfast.

The elimination of meat in the third trimester also contributes to the prevention of ruptures. If a woman is not ready for such a decision, you should at least not include smoked products in the menu.

To others preventive measures should include:

regular visits to the gynecologist, the implementation of all his recommendations;
timely registration for pregnancy (no later than 12 weeks);
attending antenatal training courses to teach proper behavior during childbirth;
timely detection inflammatory processes in the genitals and their complete cure even at the stage of pregnancy;
following all the instructions of the doctor and obstetrician during childbirth.