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BY LAUREN BRENTON | Endorsed  Midwife & Childbirth Educator | Founder of One Mama Midwife

September 2023

As new parents, there are many aspects of pregnancy, birth and parenting that are discussed openly.  However, there are some aspects of the postpartum period that aren’t discussed enough. 

In this blog, we're shedding light on three important yet rarely discussed topics - vaginal tearing, postpartum bleeding, and the first postpartum poo. We'll not only break the silence surrounding these issues but also provide valuable tips for managing and recovering from them.

1. Vaginal Tearing

Vaginal tearing occurs when the area in between the vaginal opening and the anus tears during childbirth. There are different levels of severity, with the most common type of tear for first time mothers being a second-degree tear. While the topic might be uncomfortable to discuss, acknowledging vaginal tearing and its management is crucial for a healthy postpartum recovery.

Tips for Managing Vaginal Tearing:

  • Perineal Care: Gently clean the perineal area with warm water after passing urine or opening your bowels. You can do this by using a perineum bottle or by having a shower. When you are passing urine on the toilet, gently lean forward as this will cause the stream of urine to be away from stitches which can help with healing and comfort. It is important to always pat your stitches dry and not wipe to prevent irritation and any damage to your stitches. When you are opening your bowels,
  • Icing: Icing your stitches as soon as you can after birth can help to reduce inflammation in the area. Icing for the first 48 hours, along with trying not to sit directly on your stitches can greatly reduce swelling and discomfort in the area. Once your ice has melted, discard it as you want to keep the perineum clean and dry. 
  • Sitz Baths: Taking regular warm sitz baths can provide soothing relief and promote healing. Sitz baths involve sitting in a shallow tub of warm water for around 15 minutes. The warm water can help relax your muscles and improve blood circulation to your tissues. Therefore, promoting healing and reducing pain.
  • Pain Management: Staying on top of pain relief such as Panadol or Nurofen can help improve discomfort and reduce inflammation. Always consult your healthcare provider before using any medications.
  • Pelvic Floor Exercises: Once you feel up to it after birth, very slowly ease back into doing your pelvic floor exercises to help strengthen your pelvic floor muscles. You may like to see a women’s health physiotherapist before returning to pelvic floor exercises.

2. Postpartum Bleeding

After birth all women experience postpartum bleeding, regardless of if they have given birth vaginally or by caesarean section. Postpartum bleeding is caused by the shedding of the lining of the uterus as well as the healing of the wound site that is left after the delivery of the placenta. Once the placenta is removed, a dinner plate sized wound is left behind on the uterus. For the wound site to heal, the uterus contracts down on itself to close off the open blood vessels. Sometimes these contractions can be painful and are often referred to as afterbirth pain.  

It is normal to bleed for approximately 6-8 weeks, even if you have a caesarean section as your uterus slowly returns to its pre-pregnancy size and your placental wound site heals. Your bleeding can be similar to a heavy period initially and gradually taper off over a few weeks. While it might not be a topic of casual conversation, understanding what to expect and how to manage it is crucial for a smoother recovery.

Tips for Managing Postpartum Bleeding:

  • Use the Right Products: Choose comfortable and absorbent postpartum pads or disposable underwear specifically designed for postpartum bleeding. Be sure to change pads or underwear regularly to reduce your risk of infection.  
  • Avoid Tampons: Refrain from using tampons during the postpartum period to prevent infection and promote healing.
  • Rest and Hydration: Prioritise rest and stay hydrated to support your body's recovery process. It is important that you listen to your body and not push yourself which could potentially slow down your recovery.
  • Monitor Bleeding: It is important to keep an eye out for any warning signs with your postpartum bleeding. If you are going through more than one maternity pad an hour, are having blood clots bigger than a 50c piece or your bleeding suddenly increases, and you feel unwell it is essential to call your midwife or health professional immediately.
  • Eat a Healthy Well-Balanced Diet: When you are recovering after birth, it is important to fuel your body with nutrient-rich foods to help with healing. Eating foods that are healthy, fulfilling, and rich in iron can help to replenish your stores lost due to postpartum bleeding. 

3. The First Postpartum Poo

There is one thing that many women fear after they’ve given birth – the first postpartum poo! Whilst it might not be the most glamorous topic, opening your bowels postpartum and potential digestive issues are important aspects of the recovery journey. Changes in hormones, pain medications, and factors such as soreness, fear of worsening vaginal tearing, and changes in bowel habits can make this seemingly simple task more complex.

Tips for Managing Postpartum Bowel Movements & Digestive Problems:

  • Stay Hydrated and Eat Fibre: As soon as your baby is born, it is important that you focus on increasing your water intake, this can help to soften your stools and make them easier to pass. Additionally, eating foods that are high in fibre can help to regulate your digestive system and reduce constipation. It can be helpful to pack a zip lock bag of prunes in your hospital bag to snack on throughout the day to help get in valuable fibre.
  • Gentle Exercise: Gently increasing your amount of walking around each day after birth, as you feel up to it can help to prevent constipation and keep your digestive system healthy.
  • Stool Softeners: If recommended by your healthcare provider, consider using stool softeners to make passing stool more comfortable. If you haven’t passed a bowel movement by the second or third day after birth, you may be offered a stool softener. This isn’t going to make you run to the toilet; however, it will start to encourage your bowels to move again. It is important to look for a stool softener that doesn’t draw out the moisture from the stool, as this can make the first bowel movement more painful.
  • Perineal Tears: If you have perineal tears, it is understandable that you might be apprehensive about passing your first bowel movement. It is important not to strain on the toilet, but to wait until you’re ready to go. If you are worried about your stitches, you can hold a clean cloth on your perineum to provide support and reduce discomfort.
  • Proper positioning: Don’t underestimate the importance of proper positioning when going to the toilet. When you sit on the toilet, elevate your feet on a small stool, so that your knees are higher than your thighs. This is a more natural position for passing bowel movements as it is more similar to a squat position.
  • Haemorrhoids: From the pushing during birth or constipation after birth, some women may develop haemorrhoids. It is important that if you develop haemorrhoids, to tell your healthcare provider so that they can give you cream to help. Icing and not sitting directly on the area can also help with discomfort from haemorrhoids. 
  • Wearing TheRY Group Postpartum Compression Shorts: Wearing postpartum compression shorts from TheRY Group can lead to improved abdominal support, reduced swelling, and improved comfort. This can potentially lead to less strain on the digestive system and improved digestive functioning.
  • Patience: Understand that postpartum digestive issues are common and temporary. Be patient with your body as it recovers and adjusts. 

Breaking the Silence and Building a Supportive Community

As a new parent, it's important to remember that you're not alone in your postpartum experiences. The postpartum period comes with its own set of challenges that deserve acknowledgment and support. Through being informed and prepared on what to expect in the postpartum period, especially the not so glamourous parts, can help you manage these postpartum discomforts. Therefore, allowing you to heal with confidence. Remember, seeking advice from healthcare professionals is always advisable to ensure the best care and recovery possible.

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Written by Lauren Brenton

Endorsed Midwife

Founder of One Mama Midwife Pty Ltd

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