1 week after a 3rd degree tear - sorry v. graphic, but please help!

[Homsa]

I had my baby a week ago and suffered a 3rd degree tear due to her having her hand up to her face when she came out.

I was stitched up in the OP and was pretty comfortable for the first few days in hospital. However, the hospital didn't want to let me go home until I'd had a bowel movement, and as I was desperate to leave I tried the suppositories they suggested to make me go - bad mistake! Very, very painful and uncomfortable, but nothing came out...

Discharged myself on day 4, and once at home, started passing tiny amounts of stool, and having embarassing leaks from my back passage. Some days have been bearable, but other times I feel a constant need to go to the toilet, and very little, if anything, comes out. It's incredibly distressing. My midwife says to be patient, should get better soon. I have been taking Lactulose, but have decided to stop this now as I suspect it may be making things worse.

Anyone else been through this? Have I been stitched too tightly, or is this normal? When will I feel better???

Homsa, I had a tear beyond my episiotomy when ds was pulled out with salad spoons & I was horrified to find I could barely control what was happening with my bum too!
It took me about two weeks before I could even start to hold on to a fart and not shit myself and it was about a month before I could do a proper poo, without having to hold on to my nether regions with lots of paper pressed up against them. Horribly messy, felt really embarrassing & humiliating at the time, but it did pass & I can happily tell you that 6 yrs later & another baby later I am completely continent!
So, don't worry too much. If you are still having alot of difficulty in another week, with no sign of improvement then I think you should go & see your GP.
Drink as much water as possible, it is really important to keep hydrated & eat lots of fruit & veg to get things moving.
Good luck & lots of sympathy. It is grim & yukky but I'm sure it will get better.
Congratulations too on the arrival of your baby.

Congratulations on your baby's birth.

I'm afraid it may take a bit of time for things to settle, give it a couple more weeks perhaps. Why do you think Lactulose is making things worse? It's a pretty standard drug for constipation used after birth. \link{http://www.netdoctor.co.uk/medicines/100001447.html\how lactulose works}

Homsa - sorry i have no advive to offer you, only sympathy. sounds awful! It woudl be worth searching the mumsnet archives on thsi topic as there is lots there

Congratulations on your baby

I can totally understand what you are going through, i too had a 3rd degree tear for no reason apparently i.e no hand presentation of forcepts (sp?) and what you are going through is normal..well it was the same for me, it took me a few weeks to not have accidents, and it was a case of, need a poo? RUN like hell!

I too was on lactulose, and i am not sure if it helped or not tbh, but i did take it.

I just felt the need to reassure you that it is normal to be the way you are after suffering such a bad tear, and it can't have been that bad (well...) because i am now pg with no 2!!

Congratulations on your new baby, and don't worry, it will get better soon.

xxx

I had a very similar 'leakage' problem after my 3rd degree tear etc. Because the muscles have been torn and bruised, it will take some time for them to heal and for you to have proper control. Do your pelvic floor exercises as much as you can (they will be sore but persevere) as they will help.

I'm not sure how normal it is to not passing anything, or very little though. That must be v uncomfortable for you. I think the combination of drugs they send you home with works for many people, but in some cases it isn't the best solution, for whatever reason. I think you need a second opinion. You know your body best. Don't let anyone fob you off if you are in discomfort.

Best wishes and congratulations on your baby.

Homsa - are you on iron tablets? They can make things worse i think. Agree with teh others - I woudl check it out with Gp

homsa. congratulations on your new baby's arrival. can't offer any specific advice to you but would just like to say that 1 week after having a baby, even without the tear, is still very early to expect your body to be back to normal again, give your self a bit more time.

Homsa, congratulatons on your baby's arrival I am still waiting for mine to come!

After ds was born (forceps) I was virtually doubly incontinent for twelve weeks and was in despair that I would never go back to normal. I was referred to the perineal clinic at Kings College Hospital which is excellent clinic and one of the few perineal clinics in the country - they specialise in childbirth trauma. As it turned out i 'pinged back' after twelve weeks, but if you are in London try and get referred there you may even be able to be referred wherever you live.
Good luck and I hope things improve - I felt real despair for weeks but I healed and reverted to normal.
lol

I had a 3rd degree tear after DS1 and I would continue to take the lactulose - it's to prefvent constimation as you really don't want ot be straining to go whilst your tear heals.

Drinking lots will help, as will orange juice with a spoonful of sugar added. Prunes help too. I had a third degree tear and I remember being like this (even if said baby is now 16 and making my life hell for other reasons!!!). Drinking lots and lots, light exercise (walking), lots of fruit and veg and trying to relax about it will all help. If you still have no luck in a few days, go see your doctor.

I must say this is what happened to me I discharged myself to and for about 10 days did not go to the toilet apart from leaks and my bits where really painful also I found myself tensing when I went to the loo cause I was convinced it was going to hurt I think that made the constipation worse I took lactolose to couldnt midwife check your stitching see how they are dissolving

Dear Homsa,

Don't get disheartened. I had one, and know exactly how you feel. Drink LOTS of water - it got much better for me when i clocked onto that. I also took to bran flakes (used to hate them, but grew to like them!). The lactose gave me rumblings which were uncomfortable, and also made things happen v.fast, which was a mare as I had SPD, so hot stepping it to the bathroom was a no-no.

Ask your consultant if you're worried about anything - it will make you feel better, and more confident. I know the fear of dreading a movement. Another thing i did was have a mag by the loo, which i could clutch onto and distract myself with - it sounds stupid, but it worked, and made me relax more! Keep positive, you will feel much better in a few weeks. And enjoy that baby!! xxx

Homsa, I am so sorry that you are having such discomfort. I didn't have a tear (had em
c/s) but did have terrible constipation and found that, as well as the lactulose, having a footstool or a box near the loo really helped. If you can bring your feet off the floor and balance them on a footstool, it brings you into a squatting position which is much more comfortable for having a poo when you are worried about it. If you have lots of fruit and veg as well, you will have a soft poo and it will be much easier to pass as well.

Many congratulations on your baby's arrival, and really hope you feel more comfortable soon

Homsa,
Had exactly the same problem for exactly the same reason 3 years ago. Am expecting number 2 in 10 weeks and will have an elective section this time.
You should feel better in a few weeks. I had six weeks of total misery - shi**ing myself and unable even to hold wind. It's embarrassing and worrying but you should heal eventually. Arnica tablets will help the swelling and bruising and you should really try to drink as much water as poss to help with constipation. Fresh fruit and dried apricots plus spinach and if you can face it, liver (and mash!) are all good sources of iron which you may also benefit from.
You could try spatone sachets if you need iron; they don't seem to have the same constipating effect that iron tablets can. The other thing you could ask about for being constipated is called Movicol and it's a sachet that you add to drinks. Quite inoffensive and very effective!
The leaking thing is also something that I experienced. Mine did heal up. You just have to be scrupulously clean around the tear and as has been suggested to take in a mag when you go for a poo, take deep breaths and hold a pad against the area if that helps you feel less strained.
Very best of luck and congrats on your little one. Quite a few of us on Mumsnet have had simiar experiences and the majority of us have come out of it ok. Hopefully, you will too.

Hi again everyone,
hope you're still watching this thread! I'm really grateful for all your advice, and it's been so comforting to hear that other people have gone through the same. I'm really sorry I haven't been able to post back earlier, but I've had a pretty horrible time recently! Was re-admitted to hospital on the same day as my initial post, as the mw was so worried about the leakage. Stayed in hospital over the BH weekend, had lots of examinations, enemas, laxatives - all to no avail. Was sent home again on Tuesday, and spent the next few days in absolute agony - basically had a constant need to do a poo, but just couldn't! Every movement made my bum hurt like hell, I couldn't look after my kids, couldn't sleep because of the pain - it was so miserable!

BUT this morning I managed to have a bowel movement by squatting in the shower and easing the poo out with my finger - after a few hard bits had come out, there was no holding back!

Gosh, I'm so relieved, it's been like giving birth a second time!!!!! (worse, actually)

you poor thing, big {{{{{{{{{{{hugs}}}}}}}}}

Like giving birth but without the cute baby photos... :o

I hope this is the real turning point and you make a swift recovery! Sounds terrible.

Hey, well done homsa!! The cork has been pulled!

OH Homsa, you poor love, what a terrible time you have had! glad you are feeling better and hope you are enjoying your baby! keep drinking the water! take care XX

Oh you poor thing - how very rough for you.

Two things - firstly, don't stop taking the lactulose, even if only in minimum dose. Your hormones are still all over the place, and it's quite common to get constipated as a result of the hormone fluctuations, rather than any mucking about that you've had down there. It happened to me after I'd had several good poos and thought I was 'safe', and it was absolutely hideous.

Secondly, my mum had surgery to her rectum a couple of years ago and described similar feelings to you'rs. The confused urges to go but apparently unable to are a mixture of the nerves down there being aggravated and you being terribly tense. If it helps to poo in the bath then don't be ashamed, just go ahead. Keep a plastic sieve by the bath to strain out any bits, then you can shower yourself and the tub off. You can also get a little plastic bidet that fits over the toilet seat (you fill it with fresh water of course), and that may soothe you or help you to poo.

Remember to drink lots - for your recovery, for easy pooing and for making milk.

Each time after birth I lost a lot of sensation down there - never knew that I needed to poo or wee until I was on the verge of doing it. And as for wind - not a hope to keep it back! But gradually the sensation returned, the first month made a huge difference, then the improvement slowed down a lot but kept going.

HTH

crikey homsa, you brave woman

Soupy you bad woman - I have tears rolling down my face at the baby photo thing

Homsa - I saw your thread before - my son also came out with his hand on his face but the end result was different. I am so glad I saw this and that you have actually managed to have a poo! All I can say is I feel your relief (the relief sensation will last about a week, and you have a great story if you don't like the way a dinner party is going). Gawd bless ya! Now go an eat loads of pears and prunes will ya???

Homsa - don't stop taking the lactulose. You should be on a very low residue diet for a while - it is really, really important that you don't end up constipated - but you also need to forget all that healthy, fibre stuff for now. Right now you need to have "soft" poos so that you don't end up having to strain to go to the loo as you could end up tearing again. Some people have 3rd degree tears and manage fine. Others need more help. You are having problems so get your midwife to advise properly - if she can't demand to see your consultant. I had a really shit (if you'll excuse the pun) time of it when I had DS - 4th degree tear along with all the problems that go with it - things do get better but it can take a lot of time. If things are still pretty painful try showering yourself clean instead of using loo roll. Also, get one of those footstools that someone mentioned earlier - will really help. Don't try and strain - just relax, breathe deeply, and wait. Helps to have a good magazine to hand as things can take time! Downside is that you might find the opposite of that, namely, now you can go, you don't get much warning. Physio is really important - so make sure you get referred if needs be.

hi congrats on your baby and congrats on the poo - i know how you feel. I had a similar problem. I was in the children's ward at my local a&e recently and there was a poster on the door about ideal pooing positions and (as someone said earlier) having your feet up on a stool is ideal. I still find that sometimes when i need a poo it wont come out and but find still that holding tissue over my perineal and pushing backwards on it slighlty helps - i think that at the moment things down there have changed position slighlty. I hope that now you've had some relief it begins to get better. Someone told me to steer clear of bananas as they can aggravate constipation.

Good luck and enjoy bubs.