Mid wife shrieking in horror at extent of open epistiotomy wound. All stitches undone, severe infection, any natural remedies anyone?

[Dhosonia]

1st time poster - Before starting i just want to say that i have tried to read every related post on the topic on mumsnet and elsehwere as i dont want to waste ppls time and effort but cant seem to find the answers that will help my wife anywhere. She is not posting herself as i am trying to burden the pain for her and think that the less she knows the better frame of mind she will be in and therefore cant get caught up in a cycle of negative pessamstic thinking. This was our first son - pessary/pitocin drip/epidural/epistiotomy/forceps. Was a wonderful pregancny but traumatic birth (28 hr labour) I feel very guilty and im blaiming myself for the mess wifes in now, as i was so wound up about the forceps scar after telling the registrar that we didnt want it (baby was in correct position, all stats ok for mother and baby) that i started having a go at her whilst the registrar was still stitching after birth saying that we didnt want forceps - look at his scar etc as she only let her push for 40 mins and cited maternal exhaustion as reason for forceps etc. so ive concluded she did a terrible job in stitching after i upset the registrar with my outburst. The room was also like a circus, 4 mw's 1 reg,1 nurse, 1 ped.

All her stitches have come undone and there is a horrible gaping open wound with pus and all sorts of gunk seeping out intertwined with whats left of her stiches. Birth on 27June back in hptal on 1st july. IV antibiotics - they cant restitch - offered possible repairin 4 - 6 mths. Whilst in hpital any mw's that checked reacted with horror when checking her wound. Back home today 6 july. Mw reacted with horror again at seeing it, cut is right from top of vagina to the rectum.

Its very severe and my wife is in huge amounts of pain. When showering to keep it clean should the water go inside the wound? or just softly outside. How long should she sit on the bidet - 1 min - 5 mins? Can i put manuka honey on it now or will it hurt to much/sting/cause bad reaction/make it worse. Does it go inside or just outside. The odour is going but its still full of white and black thimgs inside and is pinkish. Can i spray collodial silver on it? How long is healing time.

Thanks you for any replies we are totaly lost on this and seeing how much pain she is in is breaking my heart. Also have switched to combination feedimg as we dont want antibiotics getting through to son - is this a good idea?

Hi

Have had 4 opinions all from docs at the same hospital, 3 registrars and 1 consultant - leave it open and it will heal - but all mid wifes who see this thing regularly say it one of the worst cases they have seen - mid wife was shocked that was all they recommended (community midwife) and has referred to nurse and gp tmw not in us but lived there for 8 yrs - cant restich as skin is to supple and have to wait for infection to clear - she on diclofenac and paracetamol and lactlulose will start her on some vitamin e i think thats good - will avoid the rest of the alterative things for now - its just i have reas so many horror stories about perenium problems down the line and want to avoid. Thanks everyone, feeling a bit less guilty but i feel so helpless just want her to be allright but cant take the pain away and cant "solve" it overnight thx again

My tear has healed up very well - it didn't get infected but was all the way to the rectum and very nasty. She may well be absolutely fine in time - in the meantime just try the healing aids and keep at the medical professionals if you think it needs attention.

I can understand that the infection would need to clear before they consider restitching. If they suggest delaying restitching, then there is no harm in asking for a second opinion just to be on the safe side.

In the meantime,continue on supporting your wife as much as possible.

Offer to do as much of the practical care for your baby as you can. Do as much of the cooking, cleaning and housework as you can. If you have family and friends around, then ask your wife if she would like their support.

And just listen to how she's feeling. She may just want to offload and maybe have a go at you- try not to take it personally- tiredness and feeling unwell can make the loveliest person a bit narky!

Dhosinia, take a look at Kellymom. It's an excellent resource for evidence-based info on breastfeeding.

Thanks again for all the amazing thoughts and advice i had read mumsnet was good but this is massively encouraging to the both of us that there is help out there etc i want to give her a sea salt water bath - ive read somehwhere that research has shown - saltwater doesnt do anything? its just a colossal waste of time and might even irritate it? it would be good for her if someone can give a postive experience of it - wife is also slighlty incontinet in the rectal area as a result of the epistiotomy messing up and thats why everything is even harder than usual on her emotional wellbeing

Also i read that rubbing some breast milk on her pad (antibodies in there plus trace elements of the antibiotics she is on) will help heal?

Just offer all the practical support you can (everything Fleegle said) plus stay on top of her pain relief. Write down the times she takes her meds and remind her when they're due - equally don't let her OD!

Keep visitors (even the well meaning) away from her unless she really wants to see them. Keep visits short.

Encourage the breastfeeding (as it sounds like you are) as if it goes well than it could be very healing, emotionally, for your wife. Hopefully she has been shown how to feed lying on her side in bed - much less painful than sitting up.

I has an episiotimy and forceps with my 1st child. It resulted in a perineal haematoma and was excrutiating agony for 6 weeks. I had an initial resentment against my husband, as I'd been talked into having the epidural by him when he felt upset at seeing me in pain; and of course in the end it was because of the epidural that I needed the episiotimy.
This resentment faded fast when we pulled together to look after our baby, and he looked after me so well. We've gone on to have a further 3 children (I know, this is the furthest thing from your mind right now!) in easy births with no interventions and not even a tear. It can and will get better, and well done fr your support of your wife - she'll appreciate it when the pain stops and she notices!

I had a third degree tear but didnt have the extent of problems your wife has had. Was very uncomfortable for long time and stitches dug in to skin - once things began to heal I used Hypercal (a homeopathic cream) available at chemist and this soothed and helped with healing. When using the toilet i had a bottle which i filled with warm water which i poured over the area to clean and sooth. I also bought cooling pads to keep in the fridge - they were great! Obviously until the infection is cleared up and she begins to heal a little more these won't be relevant. I did have to have an op a year later because i had scarring as a result of the stitching which made intercourse impossible (perhaps TMI) - although i was very nervous about going back into hospital again and having another op on the area it was such a relief to feel normal again. Hope some of this may be useful

I used to squeeze breast milk onto my pads, yes.

I didn't have salt baths - I thought they would hurt. I used to get into a full bath (plain water, nothing in it) every time I needed to poo and wee though, so that the urine or poo couldn't touch the wound directly, which was agony. DH would take the poo out of the bath with a sieve for me, as well as scrubbing the bath out afterwards (that's love).

I wouldn't bother with the salt... My midwife explained that if there was enough salt in the water to make any difference, it would be strong enough to shrink the stitches.

Just go for frequent tepid baths, and it also helps to pour a jug of tepid water over yourself when you've peed to clean up.

Have you got a valley cushion or similar for her to sit on? Has she been prescribed painkillers?

this helped me with the pain I did not have anything so awful. I cringe at the thought. Hopefully the others have other ideas for you too.

for your wife. i had an epi but it didn't get infected. it was painful though. i had a bath once or twice a day if i had time with a few drops of tea tree and lavender. also my friend got me arnica tablets from a homeopath as the ones from the shops aren't so strong apparently.

good luck and i hope she's feeling better soon!

I hada very bad wound after first delivery. Regular salt baths and 100% aloe vera (preferably straight from the plant if possible)

I know it sounds very hippy, which I am not...but the aloe really helped healing...best wishes

I think you should get the opinion of another consultant.

Thanks all on advice on salt and breastmilk - the labour/birth is only part of the story - due date was 24th, due to the fact we didnt have much intercourse throughout pregnancy - mw did a sweep on 24th - on 25th waters broke, on 27th after 2 day wait they induced, during induction we found out that only t h ehindwaters had broken so we could have waited another few days for onset of natural labour as forewaters were still intact.... no one actually checked at any point to see if her waters had broken or which waters had broken - they ended up being piereced - in total he was [oked and prodded about 14 times - cervix checks etc - when she was only 2 cm dilated and looked lke she wouldnt go they wanted to do a c section - we said no and too wait for another 2 hrs - which im glad we did as she went from 2 to 7cm... from start to finish it was a calamity of errors - anyway thax again to everyone - have made notes and a plan of action for the a.m starting with second opinion/gp etc

phone first thing and ask for a same day appt tomorrow and get the wound re-checked for infection. then firmly press for re-assessing repair/restitching.

Dhonsonia, my sympathies to you and your wife. I'm glad you've got some good advice here, it sounds like she's had a terrible time.

Something that strikes me about your posts is that you're trying to take charge and fix things for your wife out of guilt and fright. That's understandable.

But sometimes you just can't make things happen by sheer force of will, no matter how good your intentions. I wonder whether you might be stressing your wife out more with all of these attempts to help. Look at your list, you've mentioned:
Manuka honey
Saltwater baths
Spraying collodial silver
Rubbing breastmilk on a pad
Starting her on Vitamin E
Pumping and dumping

I'm exhausted just reading it, and I don't have a newborn!

You've had four opinions on the stitching. The odour's going, and the skin is pinkish, that means it's healing. There is no indication that the infection is worsening. I know she's in pain, but that will lessen with the right treatment, and it sounds to me that she's getting good care.

You've said that you "go into alpha male mode" and that you are "trying to burden the pain for her and think that the less she knows the better frame of mind she will be in". With respect, and I know you're entirely wellmeaning, that's quite patronising. It's awful feeling helpless, and it's always worse with a first newborn because we're all so clueless during that time, I know that.

But I get this impression that you're spending all your time researching on the internet and coming up with different things that might help and which YOU can do; active, tangible things.

This is what will help:
Accept that you're not in charge of this situation. You didn't cause it, you can't cure it.
Listen to your wife. Ask her what she wants you to do. She might want you to back off with the treatments and bring her a cup of tea. She might want you to take the baby while she naps, or just spend time chatting with her while she breastfeeds instead of being on the internet and the phone demanding answers and solutions. You have to ask her what she wants.
Remember that you have a newborn, and he has needs as well. Spend time with him, alone, learning his ways and finding a parenting rhythm. If you're confident with him, that will take a huge burden off her, because new mothers often feel they have to guide and manage new fathers through this process, when no-one guides them.

But most of all, slow down. Stop trying to be in charge of this situation. If there's one thing pregnancy and birth teaches us it's that we can't control everything.

A bit of a side note, but have you got a rental pump for all the expressing?

Oh yes - the silver nitrate another poster mentioned is what I needed for my stitches - that was 8 weeks post-birth though.

It seems like you need to have a supportive GP onside to check your wife our regularly and make sure she is healing along with your midwife (since she's not use to cases like this). If four consultants have said she is healing, I think you need to trust that but having regular checks and support from a GP would have been a huge help to me and made me worry so much less. (We switched medical practices in part because we were not happy with my post-natal care).

One thing I should have mentioned was although I was a complete mess at 8 weeks post-partumn, I was completely healed a month later. (Except after two births, both with stitches, it's completely crooked but aside from ruling out a career as a porn star (my DH pointed that out to me) it's functional and causes me no pain or discomfort or anything.) It takes a lot longer to heal that people expect but fingers crossed it will heal fine on it's own and your wife wont have any problems a few months down the line.

It's not 4 consultants, it's 3 registrars and 1 consultant. But it's still 4 opinions and no evidence that the wound is doing anything except healing and the infection is subsiding.

Agree with tortoise

Also agree with doing wees (and poos if necessary) in the bath if possible, its a bit urgh, but better than the agony that is trying to sit on the loo.

It will get better, this is the worst bit, it will get better very soon. Be prepared for your wife to be v upset when/if she dares to have a look though. I know I was.

Tortoise thanks for that been a while since ive been evaluated like that (uni days...) admit i have been in full on panic mode, as i see the darn thing every time she is examined/cleaned so going to leave everything well alone until infection starts to clear, she's only on antibiotics for 7 days, after that no more meds other than pain which is why i ws seeking some alternative remedy to continue the healing process and avoid re - infection - she doesnt want salt baths as she thinks its going to sting to high hell, when infection starts to clear will get private hospital second opinion, she cant take the trauma of going to another hospital and being prodded/poked/examined again but as advised have now got gp and district nurse involved. Thanks again for all he thoughtful advice it means so much that ppl are listening

Excellent advice from Tortoise.

Have you made that cup of tea yet ?

Sounds like you have a plan. Try to relax, follow it, and be there for your wife and son in whatever way they need (as it is clear that you are).

All the very best for a swift and complete recovery for your wife and congratulations on the birth of your son.

sweet fucking jesus POOR WOMAN

she needs antibotics and she needs them NOW
she also needs strong STRONG painkillers, dont worry about BF they need to give her something STRONG

it really pisses me off how unsympatetic they can be about this, if it was a wound anywhere else I swear they'd react better

Please get this seen to asap

in the short term

dont sit down, lie on side, and BF on side
tea tree oil after every
get a squirty mineral water bottle and use this to clean her bits after wee/poo
cotton pants and cotton pant liners
when not BF leave her to rest and you take baby

poor her and poor you too, its hard for men too eh

Your poor wife I have been in a very similar situation twice now and it is miserable as hell, I really feel for her and for you too.

The reason they can't stitch now is that they would introduce more infection and it would never heal and could cause much worse damage. Waiting 4-6 is the only option.

Whilst it may look horrific, it is astonishing how much will heal and be just as useful as it ever was before. I don't promise that it will look pretty - I won't be appearing in Razzle now, which is a great disappointment to me - but it may well heal to the point where she is no longer bothered by it. This is what has happened to me. I have one labia ripped in half and basically no perinium, but astonishingly sex is just the same as it ever was...better if anything, and I am not in any pain or discomfort. If you had told me that after I had DS2 18, ago I would have laughed (or cried).

You should not put anything on your wife's wound unless it has been prescribed by a doctor. She needs to ring the community MW and insist on an immediate appointment with a consultant, and for some decent painkillers. I took diclofenac, co-codamol and lidocaine cream (local anaesthetic) and it was OK even though I also had a catheter rubbing on my would for 3 weeks. There is no reason for your wife to be in terrible pain (all the above compatible with breast feeding BTW).

On the subject of BF, if your wife was known to be BF at the time the antibiotics were prescribed then they are safe for your son and any negatives are far outweighed by the positive benefits of BF. You should also be aware that starting mixed feeding at this early stage is likely to result in insufficient milk supply and the end of BF in a relatively short time, but you can get qualified advice on this from the La Leche League helpline or any other BF helpline (just google).

Best wishes and good luck to you both.

Good post from tortoise.