Episiotomy with 1st delivery, now perineum feels sore in 2nd pregnancy

[bakingmad83]

Just wondered if anyone else has had similar?

I had DS via forceps delivery 2.5 years ago and needed episiotomy. Afterwards it felt like I'd been sewn up too tight, maybe just a lot of swelling, and tbh wasn't able to have sex for 5 months. By the time DS was about 9 months, all back to normal, but now I'm pregnant (currently 21 weeks) and my perineum is back to feeling sore and as if the skin is too tight. Wondering if this is an indication I'm going to tear if the scar tissue won't stretch or need another episiotomy. Know no one can answer this question for me, just looking for experiences thanks :)

Hi bakingmad83,
I don't have a full answer to your question but think I have a couple of pointers.
Hormones can really affect how the perineum feels. It can feel quite tight before or during menstruation for example. Pregnancy hormones will definitely play a part.
The other aspect is scar tissue. It gets much better over time but you can help soften it by massaging (if you haven't already done that after your first baby was born). With your thumb (slow sweep movement) , try to see if you find trigger points (soreness). If you do, press and hold. It will be sore at first but will ease over time. Also sweep from side to side with your thumb whilst stretching the perineum to the back.

If you can see a woman's health physio, that'd be ideal. They might have other tricks up their sleeve (like using dilators perhaps).

Hope this helps.

I am feeling the same with 2nd at 27 weeks, but perineum massages are helping and already have noticed some improvement. My midwife suggested it was the hormones relaxing my pelvic muscles, making the scar tissue stretch in a different way to how it originally healed.

Thanks for your reply Tchoutchou! I'd not really noticed the impact of hormones previously, as only had 3 periods between having DS and conceiving #2, so that's interesting to hear that hormonal changes naturally affect the perineum. I wasn't aware that massage was a good idea for perineal scarring, though probs should have thought about it as was advised to massage following an operation on my hand previously. I'll give that a go now. Was thinking I would try perineal massage nearer the time, did this with DS from 36 weeks, but I guess if you need forceps they end up having to cut you whatever.

Thanks for the info Blue, definitely going to give perineal massage a go now then!

I've torn and had episiotomies with both my previous two, I expect the same this time. TBH I've not noticed anything once the tear and episi heal. I'm 31 wks now w baby 3 and my only complaint is the pressure I feel! I'd love if I didn't tear etc...I can only imagine how much faster recovery would be. I tried massage with my first and ended up with crappy tearing so I don't have much faith in that.