Postpartum Vaginal Healing: Tears, Stitches and Self-Care

Postpartum vaginal healing usually takes a few weeks. Most tears and episiotomy cuts heal within about a month of the birth, stitches usually dissolve on their own, and soreness tends to ease over 2 to 3 weeks. Gentle washing, rest and avoiding straining all help.

This guide covers perineal tear healing, episiotomy stitches care, bleeding, dryness and where Clivon Gyn vaginal ovules fit. Most importantly, do not put anything inside your vagina after birth, including any ovule or pessary, until your doctor or midwife says it is safe. If your stitches may be infected, see your doctor for the right treatment.

What are perineal tears and episiotomy?

The perineum is the area between the vaginal opening and the anus. Tearing during a vaginal birth is common: the NHS says up to 9 in 10 first-time mothers who give birth vaginally have some kind of tear, graze or episiotomy.

• First-degree tears are small, skin-deep tears that usually heal naturally.
• Second-degree tears are deeper, involve the muscle of the perineum and usually need stitches.
• Third- and fourth-degree tears also involve the muscle that controls the anus. They need specialist repair and follow-up.

An episiotomy is a small cut a doctor or midwife makes in the perineum to widen the vaginal opening, for example when the baby needs to be born quickly. It is stitched afterwards.

Postpartum vaginal healing: what is normal

Most tears and cuts are repaired with dissolvable stitches. The NHS says stitches should heal within 1 month of the birth. You may see small threads on your pad as they dissolve, which is normal.

Soreness when you sit, walk or use the toilet is common and usually improves over 2 to 3 weeks, though a deeper tear can take longer. Holding a clean pad over your stitches when you poo can ease the pressure.

Bleeding after birth (lochia) and maternity pads

After any birth, vaginal or caesarean, you will have bleeding called lochia. It starts heavy and red, then slowly becomes lighter and brownish over a few weeks. It may be a little heavier while breastfeeding, as feeding helps the womb contract.

• Use maternity pads, which are longer and more absorbent than everyday pads.
• Do not use tampons or menstrual cups until after your postnatal check at around 6 weeks, as they can raise the chance of infection.
• Change pads often, more often on hot, humid days, and wash your hands before and after.

Episiotomy stitches care: keeping the area clean

• Rinse with plain warm water at least once a day, and after using the toilet. Soap and shower gel can irritate stitches.
• Use the shattaf gently. Keep the pressure low, rinse from front to back and never aim the spray inside. In a UAE summer the cold tap can run hot, so test the water on your hand first.
• Pat dry with a clean towel.
• Wear loose cotton underwear so air can reach the area.
• Skip perfumed products, such as bubble bath, scented wipes and douches.

Easing pain and discomfort

• Cool the area with a cold pack wrapped in a clean cloth for 10 to 20 minutes at a time. Never put ice straight on the skin.
• Sit on a soft cushion, and try feeding your baby lying on your side.
• Avoid straining. Drink plenty of water, especially in UAE heat and while breastfeeding, and eat fibre-rich foods such as fruit, vegetables and wholegrains.
• Try pelvic floor exercises when you feel comfortable. Your midwife or a physiotherapist can show you how.
• Rest, and accept family help in the first 40 days.

Pain relief while breastfeeding

Some pain relief is not suitable when you are breastfeeding, so ask your doctor or our pharmacist before taking anything. For feeding comfort, see our guide to breastfeeding care.

Vaginal dryness while breastfeeding

Many new mothers find the vagina feels drier than usual. Levels of the hormone oestrogen fall after birth and stay lower while you breastfeed, and oestrogen helps keep the vagina moist. This is common and often eases with time.

Once your doctor says vaginal products are safe for you, a vaginal moisturiser can help, and a water-based lubricant can make sex more comfortable. Our guide to vaginal dryness and irritation explains more.

Sex and contraception after birth

There is no set time to start having sex again. Wait until you feel ready, bleeding has stopped and any tear has healed, often after the postnatal check. Some pain at first is common, but tell your doctor if it continues. Use a water-based lubricant, as oil-based products can damage latex condoms. You can get pregnant from about 3 weeks after birth, even while breastfeeding, so ask your doctor about contraception.

Where Clivon Gyn ovules fit

Clivon Gyn is a single-use vaginal ovule (pessary) made by Mar Farma in Milan, Italy, and sold as a medical device, not a medicine, in packs of 10. According to the leaflet, it contains plant fats (hydrogenated palm and palm kernel glycerides), silica, sunflower seed oil, aloe vera leaf extract, mallow extract, vitamin E (tocopherol), sodium hyaluronate and silver.

The maker describes Clivon Gyn as a medical device that helps to maintain the vagina's natural defences, and lists it as an aid alongside the treatment of post-partum lesions (injuries after birth). The leaflet does not say which injuries it means, does not mention tears, episiotomy or stitches, and does not say how soon after birth it can be used. Clivon Gyn does not replace the treatment a doctor prescribes, and independent evidence for ovules of this type is limited.

Only after birth if your doctor advises it

As nothing should go inside the vagina until your doctor or midwife says it is safe, use Clivon Gyn after birth only if your doctor advises it. The leaflet itself says to ask a doctor before use, including if you are breastfeeding or taking other medicines. Ask too if you use another vaginal treatment.

If your doctor advises it, follow their instructions and the leaflet in the pack. The leaflet describes one ovule a day for 10 days in a row each month, for up to 6 months, preferably at bedtime while lying on your back. Wash your hands before and after use.

Postpartum care products at Bait Al Dawaa Pharmacy

None of these products treats a tear, a wound or an infection, and anything used inside the vagina must wait until your doctor says it is safe. Find more in our mother and baby collection.

• Clivon Gyn: a pack of 10 single-use vaginal ovules from Mar Farma, sold as a medical device.
• Friends Maternity Pads: highly absorbent pads for use after childbirth, with a soft, cotton-like top sheet to help keep new mothers comfortable (10 pads).
• Sebamed Intimate Wash pH 3.8: a mild, soap-free cleanser for daily intimate hygiene. Use it on the outside only, once your stitches have healed.
• Vidermina Intimate Gel: a moisturising and lubricating gel that helps relieve dryness of the intimate skin. It can be used with condoms.
• Gynofit Moisturising Gel: a vaginal gel that moisturises the intimate mucous membranes, for women with vaginal dryness (6 single-use applicators).

Using products safely after birth

• Stop any product that causes burning, itching, swelling or a rash, and ask our pharmacist.
• Clivon Gyn is for vaginal use only. Do not swallow it (if swallowed, see a doctor). Do not use it if you are allergic to any ingredient, or if the pack is damaged or out of date. If you notice unwanted effects, ask your doctor.
• Store Clivon Gyn at room temperature, away from light, heat, humidity and water, and never in a parked car.

When to see a doctor or ask our pharmacist

Contact your doctor or midwife as soon as you can if you notice:

• stitches that become more painful, or pain that gets worse instead of better
• red, swollen skin around the tear or cut
• pus, or discharge that smells unpleasant
• a fever (38°C or above), chills or shivering, or a sore, tender tummy
• a wound that seems to have opened
• bleeding that gets heavier again instead of lighter
• leaking poo or wind that you cannot control

An infected wound needs a doctor's check and the right treatment, so do not treat it yourself with an ovule, gel or wash.

Get urgent medical care if you pass clots bigger than an egg. Call an ambulance on 998 straight away if you have very heavy bleeding, such as soaking through one or more pads in an hour, or if you feel faint or dizzy.

Ask our pharmacist for help choosing pads or a moisturiser, or before taking pain relief while breastfeeding.

Frequently asked questions

How long do episiotomy stitches take to heal?

Most stitches dissolve on their own and should heal within 1 month of the birth. Soreness usually eases over 2 to 3 weeks.

Can I use Clivon Gyn ovules after giving birth?

Only if your doctor advises it. Nothing should go inside the vagina after birth until your doctor or midwife says it is safe.

Is vaginal dryness normal while breastfeeding?

Yes, it is common, because oestrogen levels are lower. A water-based lubricant can help, and your doctor can advise if it lasts.

This article is general information, not medical advice. For advice about your own health, speak to your doctor or ask our pharmacist at Bait Al Dawaa Pharmacy.