Giving birth is a rewarding and beautiful experience, but some women may experience complications that can be troubling. The most common complications are pelvic floor related and arise from episiotomies or tears in the perineum.
Sometimes these tears or cuts into the perineum can leave women with perineal pain and problems with having bowel movements. In some severe tears, women may experience difficulty holding back bowel movements.
Rarely, women may experience trouble if the repair breaks down, or becomes infected. Sometimes, women can experience fecal material coming through the vagina when a tear or cut does not properly heal.
Who is at Risk for Perineal Lacerations or Episiotomy Complications?
Women at risk include those who have experienced the following with their delivery:
- Operative vaginal delivery (use of forceps or a vacuum)
- Nulliparity (women having their first baby through the vaginal route)
- Increased fetal weight
- Fetal presentation (If the baby descends through the birth canal in an unusual presentation)
- Shoulder dystocia (When the baby’s shoulders have difficulty exiting the birth canal)
- Prolonged second stage of labor (When the mother has to push for a long time to deliver the baby)
- Epidural anesthesia
- Race (Indian and Asian descent)
Women with perineal trauma will report a variety of symptoms that include pain, loss of fecal material either through the anus or vagina, difficult defecation or a wound that will not heal.
Diagnosis and Treatment of Perineal Lacerations or Episiotomy Complications
Diagnosis is usually made through physical exam though radiology studies may also be needed.
Treatment depends on the diagnosis made. Options range from physical therapy to surgical management of the problem.