Pelvic floor/perineum – Your pelvic floor is the basket-like structure of muscles and connective tissue attached to your pelvic bones that supports your bladder, uterus and bowl and controls urine and bowl movements. It is stretched and often torn but rarely cut (episiotomy) in childbirth.
Pregnancy puts a tremendous amount of strain on the pelvic floor and vaginal delivery stretches the perineum (the area between your vagina and anus) to its natural limits, to accommodate your baby’s head. The use of instruments like a vacuum or forceps increase your chance of damaging your pelvic floor/perineum.
It is the rule not the exception to experience a tear from vaginal birth as studies show that 90% of women that deliver vaginally will have a tear. Afterward, the area will be quite painful but there are ways to manage the pain and reduce the swelling . Depending on the severity of the tear, healing time can vary from a couple weeks to months.
Vaginal tears vary from 1st to 4th degree
- First-degree tear: laceration is limited to superficial perineal skin or vaginal mucosa.
- Second-degree tear: laceration extends beyond perineal skin and vaginal mucosa to perineal muscles andconnective tissue.
- Third-degree tear: perineal skin, vaginal mucosa, muscles, and anal sphincter are torn.
- Fourth-degree tear: perineal skin, vaginal mucosa, muscles, anal sphincter, and rectal mucosa are torn.
If you gave birth vaginally without an episiotomy or a tear, your perineum will be swollen or tender afterward, but it will likely feel much better within a couple of weeks. This does not mean that your pelvic floor is completely healed as it will still need weeks if not months and exercise to regain its pre-pregnancy function.
Cryotherapy (Ice) and compression reduces both pain and swelling naturally and should be applied immediately after delivery and intermittently until the pain and swelling is gone. For added relief try numbing sprays like Dermoplast with the ice and compression.
While you’re healing, expect the discomfort to slowly improve. Contact your health care provider if the pain gets worse; the wound becomes hot, swollen and painful; or you notice a pus-like discharge. Applying counter pressure to prolapse, a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel, or the vagina itself may begin to prolapse, or fall, out of their normal positions, will relieve discomfort and aid in healing.
Not all women who deliver vaginally experience actual prolapse, but most women have heaviness and a “falling out” feeling after delivery that can also be helped with proper pelvic floor support and cryotherapy (ice) provided by a pelvic brace or support.