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?

god I am sorry, sounds awful

about the feeding, if the antibiotic is ok for breastfeeding I would just go with it and not bother with combination feeding (unless your wife is too poorly in which case do whatever she feels like).

I am sorry that I can't help with the wound issue other than to say that SURELY the doctors must be able to do something? Have you asked for a second opinion?

I am sure someone more knowledgable will be along soon, but just wanted to say don't feel guilty, you were in an emotional state yourself.

I meant to say that I think that the benefits of breastfeeding would outweigh the added antibiotic, it is very common for new mothers to be given antibiotics and to continue breastfeeding, as long as it is a suitable one.

Oh that all sounds horrendous how awful for both of you

I don't have any medical advice but hopefully someone will be along in a minute who knows more. It sounds like you have lots of questions the midwife should be able to answer about the wound as she can actually examine it.

Please keep posting as this board is an invaluable source of info. There are plenty of medical folk on here hopefully they will be here soon!

Good luck to both of you, you have had a very tough time. I had a forceps delivery and know how awful it can be.

Congratulations on your son !!!

I was going to say exactly the same as Humphrey, but also add the idea of maybe a ring cushion for her to sit on in the meantime? & also drink lots so that her wee is diluted so it stings less when she goes (it may seem logical to not drink to prevent it at all, but it really is better to go more often with it being mostly water!)

Oh you poor ,poor things .
What a lovely partner you sound .
Don't spend a nano second more thinking that this might somehow be your fault - they're proffesionals ,doing a job they do ,and have done ,hundreds of time .
I'm sure that they can cope with a distraught husband ,other stuff going on around them .
Am copying some advice from a local forum that i think is relevant ,may help until others post .

"Infected stitches are also normal and common. Keeping clean and dry is crucial. A hairdryer on cool setting on the stitches after bathing, some say salt water baths help, a valley cushion (hire from Alison Tunley: 0207 639 6366 0207 639 6366 ) or a small travel cushion for sitting on, try to get unbleached maternity pads and change them frequently to avoid irritation and reinfection. Finally some Mums find using a squirty water bottle/ sports water bottle to mix warm water into the stream when they wee helps to reduce any stinging. Also watch your diet - lots of fruit and veg and water (steer clear of citrus fruits - it won't help the stinging) to avoid any constipation (ouch!)."

"got an nct catalogue in the post and saw these feme pads (with inserts you freeze!) which sound like they could be helpful. haven't used them myself but thought i'd give you the link.

[www.nctshop.co.uk]

if link doesn't work for some reason. put 'feme pad' in nct shop search box and it comes up."

"I had 3rd degree tears (fortunately not infected) and found lavender essential oil in my bath alternated with salt/savlon baths really soothed them "
Hope more advice on way soon .

Also ,advice is that afterwards ,when well enough ,go back to hospital and request to meet with the midwives and see your birthnotes and talk through exactly what happened .
People swear this helps them come to terms with bad /traumatic birth .
But that's for later I think .

your poor wife. Perhaps sitting in a warm bath would give some relief? When going to the loo, keep a jug of warm water by the loo to pour over her sore bits to prevent stinging. From googling it looks like there may be a topical spray on numbing agent to numb the area - dermoplast? But I would get advice from MW before using anything like that.

Other than that I would try and keep the wound clean and dry, she should drink plenty of fluids obviously, and the antib's should be safe for breastfeeding - midwife will be able to confirm this.

Hello Dhosonia - congratulations to you and your wife on the arrival of our son and many sympathies with your wife. Sounds very similar to my experience - I was lucky enough to have good health support and can echo much of the good advice on here. I was advised that the pain is likely to be more from the infection than from the wound and therefore once the infection starts to clear, the pain should subside. I was also advised against restitching - consultant felt it was better for the wound to heal from the 'inside up'. I was advised by a very sympathetic GP to take warm salt water baths/washes to keep the wound clean and to relieve some of the pain. Can also echo using a jug/water whilst passing urine to help dilute/relieve stinging. The fem pads that violet queen mentioned can also be purchased from Mothercare - they help with the pain too. I hope she recovers soon - once the infection clears it will start to feel better. Also hope that this isn't clouding her ability to enjoy these early days with your son. Take care

Another PS ,don't know how relevant but common pratice in my locality that District Nurses use honey ( it's special medical grade honey on prescrip ) on leg ulcers .
Using at present on my mum ,they squirt it onto a dressing and put dressing onto ulcer .
No stinging .
They use it when wound has " slough " by which i think they mean dead ,slightly yellow flesh .

until you can get fem pads you could wrap some ice in a newborn nappy to use as a pad to take the swelling down/numb the area a bit.

Your poor wife, that sounds awful. Please don't beat yourself up with blame either, birthing is a busy business and I'm sure everyone was trying their very best for your wife and child. Congratulations on your son too

I have had some experience like your wife - but nothing like as traumatic or gruesome. My last birth (last September) I had a 2nd degree tear. I was stitched by midwives, but the stitches were coming loose within a couple of days. I too was told there would be no re-stitching, and had an open gaping wound. They swabbed me and gave antibiotics as an infection was starting (fortunately never got to the weeping pus stage). It was very sore for a couple of weeks and my movement was very restricted as I was terrified of re-opening any healing. My midwives pointed out that in many parts of the world these kind of childbirth injuries are common and are not treated by surgery. Though they did tell me that re-stitching can be undertaken after 6 months if the healing has not gone well.

I was advised to have at least one bath a day in salty water with a few drops of tea-tree and lavender oil. Whenever I went to the toilet I was scrupulous about keeping it clean and used a douche to wash after (bidet just as good). The only pain relief I was advised to take was paracetamol.

Obviously she will be coping with lochia at the same time so will be wearing some kind of sanitary protection. I found that all pads irritated in some way and kept everything hot and sticky. So I cut up some old t-shirts and folded them into a wide pad instead. Once the lochia ended I still needed some protection for a few more weeks as the wound wept clearish liquid until it healed (good sign of healing).

By my 6 weeks check the wound was pretty much healed and all pain was gone. It has all turned out OK down there, no obvious difference if you see what I mean, and all working.

I realise your wife has a far worse tear then I had, but just wanted to reassure you that these kinds of wounds do heal. She will need a lot of support in the early days - sounds like you are doing a wonderful job already . If she is in a lot of pain sitting then maybe try and hire a valley cushion from the NCT?

Thanks for all advice - i read somehwre that rubbing some of the breastmilk which also currently has trace elements of antibotics in them onto the maternity pad will help heal - or will this make matters worse. Have seen consultant and 3 registrars - all say leave it - MW expressed massive concerens (community) and reeled in horror when she saw the extent of the wound as did hospital mid wifes which is not an encouraging reaction - cmw has arranged gp and nurse - any other advise moset welcome - have also posted somewhere else on musmnet as was not aware of birth injuries thread - thanks again - feeling a bit less guilty now after what posters have said - but wife still balmes me as i went into alphal male protector mode after i saw the forceps scar and was too busy ranting and asking questions - but was only for 5 mins or so and did talk to het throughout the 5 mins but from the other side of the room. I just hope and pray she gets better quickly so she can enjoy our little man

just an idea but salt water works wonders on wounds...keep doing what you are doing lovely to see the support you are giving her..

thanks you so much lion star sorry for what you went through can take some postives from your story thanks for taking time to share and post and mothercare pads will check tmw

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

Oh goodness, I am so sorry.

Good advice has already been given here. The only other thing I could think of was for her to lie naked on her bottom half as much as possible with a towel under her to catch the lochia, so that you minimise the sweat and heat in there and allow the air to circulate. It doesn't sound like she'll be going out much at the moment anyway.

Otherwise, I don't have much else that hasn't already been said. The only thing I would say is that if you're not happy how things are healing in a couple of days - get a second, third, tenth opinion.

I am so sorry you've both had this experience. Try and be kind to yourselves in every other aspect of daily life at the moment - forget the housework, eat nice food, get as much sleep as you both possibly can whenever your little one sleeps - and hopefully all those things will minimise the trauma and suffering and help your body rest and heal.

my health visitor recommended soaking the maternity pads with witch hazel that had been kept in the fridge - worked a treat.

I'm sure that she doesn't really blame you - she's in pain and her hormones are all over the place. I remember it well, my partner got the brunt of my pain and frustration when I went through something similar.

In the end I accepted my GP's offer of some whacking strong painkillers - you've mentioned natural remedies but she can take cocodamol and breast feed safely.

Your wife doesn't blame you, I'm sure. It's a really difficult time for you both - she's in a lot of pain, she's hormonal, she's scared & she's coming to terms with having a new baby & all that means (no sleep!).

She's not feeling her most rational at the moment. Just be patient with her - you seem to be being lovely.

Oh goodness yes - take the drugs!!!

How utterly horrendous,I am feeling so sorry for your poor wife,you,all of you! My only advice is homoeopathic-hypercal tincure,diluted in boiled water,and trickled on the wound.(you can trickle it from a clean flannel or cotton wool if a jug is too much pressure).Then take the tablet form remedies calendula,arnica,and bellis perennis all in 200c twice a day for two or three days.If you call the homoeopathic pharmacy Ainsworths on new cavendish st london they will send any remedies and also would be happy to have a homoeopath advise you.they post next day delivery so call in the morning or if you are in London try and whizz over.Hypercal is a wonder treatment for nasty wounds and helps stop infection and heal the whole thing up.she will need the other remedies for bruising and tissue trauma.they would probably suggest something for the emotional trauma too-maybe staphisagria.None of this will harm your wife at all and even if you don't use homoeopathy usually is really worth a shot.
hope all is much better soon and congratulations,Daddy!

I had a similar prob with my stitches.

Tea tree oil in bath, sleep without pads or underwear, don't worry to much about keeping it clean, that can make it worse and irritate it more if you are washing with soap over and over again.

Most important; keep on top of the pain. She should be having something every 2 hours otherwise the pain starts to build up and it's harder to get it down again.
I had codine, diclofenac and paracetamol on rotation every 2 hours.
If I forgot my pain meds things got very bad indeed, this pain coupled with the baby blues is very hard to take.

FWIW, I found ice did NOT help as when the blood returned to the area the pain was 10 times worse.

Sounds rather like my experience, had an episiotomy, unfortunately DD then came out with so much force, that tore even further, also previous episiotomy scar opened up again.
Stitches then came undone, few courses of antibiotics as had mega infection, was torn pretty much front to back,not good, can totally sympathise with ur wife.
I kept cotton wool pads in bathroom and used teatree in warm water alternating with salt water ever time I went to loo.
I continued breastfeeding and took stronger painkillers when I needed them.
Totally too much info coming up, although there was a lot of pus etc, what I thought initially was pus turned out to be stitches and different layer of skin underneath.

It did heal eventually, bout 12 weeks to be totally fine, healed from inside out and wound kept getting shallower.

I might go in for a repair at some point, but the thought if going through it all again is not great.

Would be pretty annoyed at midwives reaction, my midwives just concentrated on reassuring me that it would heal in time.

Best wishes to your wife, both of u need to be kind to yourselves, no one is to blame.

Dhosonia, I'm a midwife and will try to answer what I can.

First of all please do not blame yourself. Its understandable that after a traumatic delivery you may say something to the registrar. It won't have been the first time and Drs are/should be professional enough to cope with that without it upsetting them to the extent of bodging up suturing. Sometimes suturing just doesn't take well. It may be due to the infection that the epis has broken down. The midwies don't sound like they have been very professional if they've reacted in horror! Not what your wife needs.

Is your wife taking good painkillers such as diclofenac? My gut reaction is to say don't put any honey on it. However I am a labour ward midwife so not very up to speed on wound aftercare. A friend of mine had an epis that broke down and it was a right mess. She kept coming back to the hospital to have it checked by me and one of the Drs. They never said about putting anyting on it, it did heal by itself and not require surgery. It can seem like it takes a long time to heal as it will heal from inside to out if that makes sense.

If you want good wound advice then maybe talk to the district nurse. They really are the experts on wound management and I'd have thought would have more idea than most midwives.

I don't think that combination feeding is a good idea. The antibiotics will be safe for breastfeeding, yes a small amount will cross the breastmilk and I do understand some concern about early exposure to entibiotics. But its such a small amount I think the pros outweigh the cons. Combination feeding in the early days can affect supply. Even if your wife expresses at a missed feed she's unlikely to get as much milk as a baby would and this could cause a decrease in supply.

I hope this gets sorted, not a nice start to family life.

So sorry for our wife and your pain.

In your post, you talked about colloidal silver which I've used for similar infection after surgery - if she is using pads and it's too painful to spray directly on, then spray onto pad? Also she could take 20-30 sprays orally so as she gives her body a healing chance from the inside.

You could also try a homeopath for infection (I used Calendula cream / ointment once the infection had cleared up which ensured the skin healed quite well, much to the amazement and annoyance of my doc as he dismissed the homeeopathic stuff and silver had actually done anything!!!!) and then 'normal' painkillers and ibuprofen for inflammation.

Finally, and this won't change how you feel, but please don't blame yourself. It's rubbish to feel so useless but this is not your fault at all. Just coming here and asking for help is an awesome show for affection for you wife.

I wish you guys well and hope your new addition brings you much joy.

Sorry re: spelling - v tired!!!

Of course I meant your wife not our wife!!