Help- postpartum vaginal pain

[Tra06]

I’m 8 weeks postpartum today.
quick summary of my horrendous birth
forceps, 3a degree tear, dehisced episiotomy, 3.25L blood loss. 10lb baby with shoulder dystocia (had no clue, just saw it on my discharge paperwork which was fab)

since my birth if constant had a right sided throbbing pain where my labia sits from my clitorus all the way to my vaginal entrance. It feels literally like I’ve been kicked by a horse just on that side. This past week I’ve started sitting up more, walking abit more and it’s agony.

as a side note, I am convinced I may have prolapse due to a stuck in tampon sensation. Saw physio as part of 3a tear follow up who said everything’s healing well, but front vaginal wall has some ‘laxity’ and is weak, which should strengthen with kegels. She also mentioned my labia and vagina is very red (I’ve been using replens as I’m convinced breastfeeding has given me vaginal atrophy aka a menopausal vagina as it burns and my labia have shrunk to a pea size)

please please has anyone every experienced anything like this? What did it end up being?

im see Gynae privately and going to demand and MRI because I just want to know what’s wrong with me, but am praying it’s just normal bruising from forceps and that it will go with time. If anyone has experienced this please do tell me your story, I’m really feeling so so low.

Congrats on your little one, sorry you've had such a rubbish time recovering.

Could the soreness be granulation tissue? Bright red, angry looking, burns and stings like hell when you pee? It's caused by scar tissue overgrowing. I had this after DS and they eventually fixed it with silver nitrate. The relief after two months of being in agony was immense, and it's a very quick fix.

I also had a moderate prolapse after I had DS and was doubly incontinent for a few weeks post partum. The poo probs resolved but bladder issues and sagging feeling were a bit more long term but it improved massively with time, even more once DS was weaned and then even more after a couple of months of pelvic physio (on the NHS) and by his 1st bday things were pretty much sorted. These days my symptoms are only mildly annoying the week before my period.

8 weeks with a new baby and in constant pain feels like a lifetime, you should deffo push for answers. But also please don't panic, things will get better it just sometimes takes a while xx

Thankyou so much @tpmumtobe - if anything it looks like there’s not enough tissue!! Everywhere is just dry, chaffing and red raw so I feel like they’d need to cauterise my whole vagina. Thankfully as yet I don’t get any stinging when I pee- weirdly sitting on the loo is the only time I feel no pain, that and first thing in the morning!

so greatful to hear things got miles better despite your prolapse. How was it diagnosed? And did you find it hard to do kegels ‘properly’? My physio said I’m using my buttocks too much but without using that it feels so weak!

What an ordeal, you poor woman. Congrats on baby. Re symptoms, have you asked about a haematoma? Sounds like there may be possibly retained blood somewhere, which will need releasing as won't usually heal on its own. Otherwise, it doesnt sound like a prolapse but hard to say without a clinical eye. Has your episiotomy wound become inflamed?
Really hope you get some helpful medical assistance soon, and also that you have lots of pain relief.

Just rereading this, breastfeeding should not cause vaginal atrophy, at all.
Possibly the major trauma of the forceps has caused tissue damage, and inflamation. Double check re haematoma also, as mentioned. Really feel for you. This won't help right now, but honestly this will pass, it will take time, but you will heal.
I had a horrific birth in 2006, posted lots on here, got loads of help, and surprised myself by having 2 more.

Mine was diagnosed by the physio. The GP referred me when I turned up sobbing 6 wks after he was born. Sobbing always helps I find :) I found it very hard to get the exercises right but the weekly physio helped with checking I was getting it, slowly. There used to be a mumsnet user years ago called gussiegrips I think? She was a pelvic physio and had loads of great advice. I 'think' this is her website:www.gussetgrippers.co.uk/about

I can recommend the NHS squeezy app to remind you to do them too. Longer term, pilates really helps too.

The soreness sounds awful. Arnica tablets helped me loads with bruising, worth chewing a bucketload of them in the meantime! If it is dryness from a drop in estrogen see if they'll give you the topical oestrogen cream Ovestin. I use it for peri-meno symptoms and it makes a big difference.

Sorry to hijack but the mention of arnica makes me laugh, I had a huge episiotomy amd an incision on the other side also to release a 10cm haematoma, so essentially 2 episiotomies, I sent my husband to the pharmacy for arnica as midwives advised it, and he and the male pharmacist decided that the gel arnica was the best option for me. Gobshites 😂

@justforthisnow Amazing. Hope you told them both where to shove it 🤣

Oh I did, only wish I was as good then as I am now, I'd have told them a lot more. By the time we know what to say, we're a bit beyond conception age, its a conspiracy 😂

@justforthisnow rhats exactly what I was worried about as I have a medical background :( but the only thing that makes me feel like maybe it isn’t is that when I first wake up from sleep it’s probably a 3/10- I’m aware it’s there but wouldn’t stop me going about my day if it stayed at that level. After an hour of sitting it suddenly escalates. Going to push for some sort of scan.
episiotomy wound isn’t inflamed thank the lord- no pus or anything, but it didn’t heal perfectly due to the dehiscence so the entrance to my vagina is slightly skewed and almost has a V shape. The redness is mainly internal and on the labial lips

@justforthisnow oh what seriously? I thought BF can drop your oestrogen so low that it can cause a menopausal vagina :( I really have no clue what’s happened to my body and I’m so scared I’ll feel like this forever.
do you mind sharing your birth story and how long it took for you to feel okay? I can’t ever imagine being intimate with my husband, returning to work, even enjoying my life let alone another baby, which makes me so sad because I’m an only child myself and really wanted more before all this

@tpmumtobe I’ll definately contact the GP re the pessaries- I was abit reluctant as I have migraines but I’ll see what they say, can I ask how long they took for you to feel ‘okay’ down below?

I took arnica for 5 weeks straight!! Was guzzling them down and then stopped once I saw the episiotomy had started to close. May start it back up :(

@justforthisnow Omg I just realised this was you..how did you even cope with the pain?? I’m so sorry you had to deal with that. I still shudder about those first weeks and how painful the episiotomy was. Couldn’t sit till week 5. Also can I ask (sounds dumb as yours sounded huge so I’m sure it’s a yes) but was your haematoma pain constant? Could you see bruising externally? My labia on the right was swollen to begin with but seems to have improved with time, just a tiiiiiny bit darker in the fold but honestly with a quick glance you wouldn’t see anything

Only seeing these now, will try to answer. Yes , the bruising was visible externally but it happened during delivery and swelling was so bad they decided to release haematoma immediately, so blood loss was easily 1l or so between all the physical trauma. My HB was 7 post delivery. No transfusion tho as I appeared so "good". I was traumatised tbh. I couldnt sit down properly for about 5 weeks. We didnt have sex for about 5 months. Half the right labia was missing, the large epis and bad suture job. The inside was sewn badly and caught me like it was too tight, it was like 1 stitch was sewn onto wrong part and pulled everytime I moved. That didnt resolve til baby 2, when I think it tore a bit, which was the best, as it released the tension. I was on arnica (oral) for about 2 weeks but not sure it did anything. I would push for further investigation if I were you, a scan at least. Poor you.

So sorry you’re suffering OP. I have a similar story (much less traumatic than yours, only 2L PPH, rotational forceps and 3a tear from an epis which tore through) and with pelvic physio for 10 months post-partum the ‘dragging’ prolapsey feeling resolved at around 11 months. Conceived DC2 at 13 months and await her arrival any day now: there is hope.

However: my repair job was stellar and did not dehisce. I remember my physio saying that dehisced episiotomies sometimes took up to 20 weeks to heal. It sounds like you might have some labial bruising or secondary lacerations? I can imagine that would be common with traction/lift-out forceps. My secondary lacs (internal and external) healed within 10 weeks and were entirely pain-free from 12 months. That sounds like a long time but it was manageable for me personally.

One thing i thought of re. your PPH - did you have a blood/iron transfusion? Has anyone done your bloods recently? Low iron can inhibit healing, as does sleep deprivation of course!! Bf is not related other than heavy blood loss can delay milk coming in. Obviously you are past that now and feeding successfully, so well done for that!
Really hope your recovery picks up from this point onwards. All the best to you.

So I went to the GP and apparently all my pain is from granulation at the entrance of my vagina where the episotomy started :( shes given me hydrocortisone to use 3x a day, and to continue with the oestrogen pessaries. Has anyone had this and had it resolve? If not, how did it resolve in the end? So scared it will never heal

@LabradorFiasco thats INCREDIBLE how similar our stories our. It gives me sooooo much hope that your prolapse got better with kegels. I’m praying mine does too :( thankfully I’m not anaemic! I had 4 transfusions in hospital (on my demands)
I think your right that my labia are likely very bruised. Going to give myself more grace and give it more months. Hoping I can heal all the way up so I can go back to work pain free and play with my baby freely too!

Congratulations on your new baby!
Have you talked to your HV about it and asked her to have a check? I had some concerns 7wk pp and my hv had me lie on the bed upstairs and had a look. It was also where you're describing the pain (if I've got it right) I have a vein there that I remember swelling quite a lot after birth. It caused me pain like you've described and I was shocked when I looked and realised that's where it was radiating from
I didn't get to the bottom of it. If went away on its own with painkillers. Did you have PGP?

So pleased the GP has pinpointed what's going on. If you don't get any relief with the hydrocortisone please push for silver nitrate, it's miraculous stuff and got rid of my granulation tissue in seconds, I felt ten thousand times better walking out than I did walking in!

@tpmumtobe oh wow that’s amazing! Where abouts was your granulation? Did it hurt getting it done?

@twoandcooplease no I had a great pregnancy really, day before I gave birth at 41 weeks I did 10,000 steps and he was 4.4kg at birth!
did you notice anything externally with the vein? It does feel like bruising all down my right labia which is the side of the episotomy, so maybe it is that. How long did it take to go? Would it hurt more when you sat? I find that aggravated it. But also been told I have granulation on that side

@Tra06 I had a tear that was left to heal naturally. Suffice to say it didn't! Procedure didn't hurt at all - tbh the granulation pain was so bad I would have dealt with anything to get it sorted but it just made the pain vanish instantly. DS was screaming for a feed so I ended up feeding him while they did it!

@tpmumtobe that sounds amazing! The tricky thing with mine is they seem to be inside the entrance of the vagina :( and I can see one literally on my vaginal wall…so no clue if they can burn it off but will ask gynae this Friday when I see her privately!! Mine was an episiotomy which opened up week two- being a woman SUCKS. Are you totally pain free and feeling normal now with everything down below?

@Tra06 Well DS is 9 now so to be fair it's been a while :) but yep, all back to normal. The silver nitrate fix was instant and the prolapse stuff resolved after a few months of physio. I steer clear of trampolines though. Hang in there, you will feel better!

@tpmumtobe im so glad to hear! Did you need any cautery internally?