When the sphincter tears Many women tear their pelvic floor when they give birth. For some of them, the tear extends all the way down to the rectal sphincter muscle. This was the type of tear you sustained when you gave birth. The tearing of the rectal sphincter may make it difficult for you to control the passing of wind, urine and, in rare cases, bowel movements. A day or so after the birth, a physiotherapist will come and talk to you. The physiotherapist will tell you how to look after yourself while the tear is healing. Pain relief During the first few weeks after the birth, you may experience stinging and you will have some swelling and soreness where the tear occurred. When the stitches begin to tighten, you may experience a pricking sensation and/or itching. You are likely to experience stinging, a pricking sensation and soreness for the first month. You will be offered painkillers while you are in hospital. Even if you are breastfeeding, you can continue to take the painkillers (paracetamol-based) on your return home, e.g. 2 paracetamol tablets 3-4 times a day. Lidocaingel 2% (available over the counter at the pharmacy) can be applied in the case of perineal pain. Ice pad We recommend the use of an ice pad, which is available on D2. Use the ice pad for 15 minutes every other hour or so. The ice pad helps to relieve the pain and reduces the swelling, helping you to heal faster. You can continue to use the ice pad for as long as you need to. Ask a member of staff how to make an ice pad. Keep things moving It is important not to become constipated or to sit and strain during a bowel movement. This is important in order to reduce the pressure on your pelvic floor while the tear is healing. We recommend that you take an ordinary laxative such as Magnesia, which softens the stools, making them easier to pass. You could, for example, take 1–2 Magnesia in the evening. You will be offered Magnesia while you are in hospital and you can continue to take it when you come home. It is better for your pelvic floor to continue taking the laxative than to become constipated. Stop taking the laxative if it gives you diarrhoea. Eat food high in fibre and regularly. Drink 2-3 litres of fluid a day. Hygiene It is OK to gently pat yourself dry after peeing. If it stings when you pee, it might help to shower as you pee. For the first 3-4 weeks after giving birth, you should wash yourself rather than wipe after a bowel movement. Then pat the skin dry with a soft towel. Press a folded flannel/ sanitary towel against the perineum when you have a bowel movement. 3
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