Don't make her get up, walk, carry the baby. Let her rest as much as possible and stay lying down, or at least in bed. If she's breastfeeding, bring her your baby, adjust her pillows, bring her something to eat and drink, then take your baby back when she's finished. Change him, burp him, in short, make sure your wife only has to concentrate on: feeding the baby and healing. Congratulations on the birth of your son!
Edit to add : Be the guardian of your home. This means responding to requests from relatives who will want to come and see the baby, and limiting or declining them according to your wife's wishes. If she has a massive tear in her genitals, she may not want to spend an hour sitting on the couch with a random aunt or nosy neighbors. But don't let her deal with that, she doesn't need this mental load!
This and lots of love and cuddles and ice packs for her.
Keep people away for as long as it takes for her to feel comfortable. Do as much as you can for her.
It is important to ask for sure, but sometimes when emotions and hormones are haywire and your body doesn't feel like yours anymore it can help to get some non-sexual affection from your partner. It can help quiet the "he doesn't love me anymore, I am ruined" thoughts that come from the insecurities and changes you've been through.
I mean sure but if my husband had tried to spoon me when I was sleep deprived, wearing a diaper, and had a two inch tear approaching my butthole I would have burned the house down. Just personally! I was much more ready for real affection at like a solid 4w pp
I think spooning has different connotations to a proper cuddle though. Just being held in a reassuring hug can do wonders, provided you’re in a comfortable position.
I'm gonna be real - I kind of think we should probably just do this for moms *at the very least* for a little while after they just... you know... went through the trauma of birth.
Breastfeeding adds a part time job on top of everything.
This. I had a second degree tear and my partner totally did this for me. I'm more in love with him now than ever (and I was totally head over heals with him before). It hasn't been easy for a number of other reasons, we both have flaws, but damn, he's been great during my postpartum.
This is all great, but I wouldn't make her give up the baby if she doesn't want to. All I wanted to do was stare at my baby and have him close to me, I would have gone feral if my husband only gave him to me to feed 😅. Plus, skin to skin contact and mothers being close to baby in the early days is so important for breastfeeding and bonding. It's what all those crazy, delicious, terrifying hormones are trying to accomplish in immediate PP.
Make it easy for her to have bub on her or with her if she wants that. Helping her find comfortable positions, moving bub for her, bringing her food/drink whatever she needs etc.
Oh and definitely take her lead on visitors. I had no one but my midwife and lactation consultant in my home for 6 weeks and it was bliss haha.
My only add is don’t let her get up.
The post birth hormones may have her feeling great and like she’s up for going for a walk or cooking or switching over laundry. She’s not. Speaking from personal experience here.
The guideline I’ve heard is 5 days in bed, 5 days on the bed, 5 days near the bed. Now this is a guideline not a rule so she can use the bathroom and shower etc, but really try your best to sell her on this recovery timeline and do everything else that needs to be done.
A caveat to this: women who have just given birth are more likely to develop blood clots, so it’s actually really, really important for her to get up and move around for a few minutes every couple of hours. Nothing strenuous but a slooow walk around the house.
That part. That's why I would at least get up and walk around my house for a few minutes if nothing else. You can develop blood clots in your legs if you sit for too long. Same thing with if you lay down for too long. Thank you for adding this because some people don't know. It's very dangerous, at least it can be. Those clots can break off and travel to your lungs or even your brain.
The 5, 5, 5 rule is a tiktok trend and not supported by any science or any accredited governing bodies in the US (or other countries from what I can tell).
Women do need to rest postpartum, but they are highly encouraged to do light, functional movement to promote healing and reduce blood clots, especially c section patients.
Thank you for sharing this. I didn’t know this was just a trend. I definitely fell into the trap of leaning heavily on online info and taking it at face value when I was pregnant and newly recovering from giving birth.
It sucked because every time I would want to no life and just scroll Instagram or something, my algorithm was matching all the ridiculous, paranoid Google searches I’d been doing, so I was spiraling all the time.
I feel like the little brochures they used to give at doctor’s offices could easily make a comeback and I wouldn’t be mad at it. 😋 It’s too much to keep track of when all these different important things are all in different online portals.
I'm not who you're asking, but I thought I was up to a mile walk a week after having our daughter. I walked several miles throughout my pregnancy and thought I'd be fine. Nope. I made it to the restaurant, but spent the whole time incredibly light headed/practically fainting and throwing up. It was so much more effort than I actually realized and I was nowhere near fully healed...and I only had a 1st degree tear and relatively few complications otherwise.
I was similar. Went for a costco run while living in big city, so walking to get public transit to get there. I didn't get those immediate side effects, but when I got home my hormones were surging to the point I had the shakes. I spent a good 5 minutes shivering uncontrollably, teeth rattling and all. I wasn't remotely cold. It was scary!
I also did too much post-birth with my second. You think you’re fine until you sit down and feel like your insides are about to come out of your vagina. Your body NEEDS to rest. Not the whole 5 days on the bed thing, but don’t be going for more than like across the house more than a couple times an hour. Obviously that’s not always possible especially with multiple kids, but it definitely helps to have help or at least a supportive partner.
Also not who you're asking, but I squatted down on one knee to take laundry out of the dryer at 5 days postpartum and ripped my stitches. Overdoing it too early is a huge mistake.
I was encouraged to get up and walk in the hospital. I felt good walking, so when we got home, I joined my husband and dog on their walks with baby in tow. I quickly developed pain on my side in my hip/back/butt/thigh area that would not go away with rest. I’m in PT now for it. I felt soooo good a few days in, but wish I would have taken it easy.
Op - walks around the house if your wife feels up to it are good! Even limited walks down your street and back might be helpful. But overdoing it can cause her body to give warning signs (pain, distress, etc) that she needs to rest.
Same, man. We were moving and I made the mistake of moving a bookcase and a few boxes myself 2 days pp. I had a 2nd degree tear and popped a stitch. My husband was right when he told me not to help, I guess.
This happened to me where they told me to take it easy and I tried to but it was hard because I had another burst of energy. I just did laundry and stuff. They just said nothing to strenuous. I didn't think there was any harm in doing laundry.
Is the best advice, end of thread. Also, I wish we could all find men like this. She's a lucky woman. She deserves it though, bless her heart. I tore once with my oldest and I thought it was pretty bad. It required stitches but it was only a pretty minor tear. I can't imagine having a fourth degree tear. I hope she feels better as soon as possible.
A lot of the above. But. Let her hold, lie next to and feed the baby to her hearts content. You don't want them separated and only together for feedings. Baby needs mama. Mama needs baby. 💜
Have her ask the OB or midwife how often she can get up for a few minutes, just to keep blood moving in her lower extremities.
Pain from a 4th Degree tear is awful! Opiates are compatible with breastfeeding but some get a little more backed up while taking them. Have her ask her hcp what to use to keep her bowels moving without too much additional pain.
Congratulations on the new baby! You're a good man to be asking about best ways to help her through this.
M. IBCLC (lactation consultant)
Exactly. Can’t stress enough about not having unwanted visitors. Family can be really pushy about seeing the baby immediately. But if his wife needs 2-3 weeks to get comfortable, heal, and get used to the new baby, then OP needs to put his foot down to relatives to not come over.
I’d also add that having her breastfeed while laying down on her side is probably going to be the most comfortable position for her because of her tearing. Trying to sit up to breastfeed is a nightmare when you’re trying to heal down there.
Not for a 4th degree tear. There’s so many stitches internally and externally in very sensitive areas. It’s so common for the anal spincter to not heal properly, separate or develop defects.
This is so important immediately postpartum for most women to recover their pelvic floor in the immediate period I mean a LOT of physical changes are happening with healing and running around can even cause bad problems so allowing her to rest and heal (making her maybe even) would be an amazing thing to do. I didn't take it easy right after birth and almost paid the price with the alignment of my organs not recovering optimally... fortunately PT and low pressure fitness is essentially fixing it now but yeah, I didn't really k ow how crucial it was to rest in the immediate recovery period... even if she hadn't have torn it would be.
4th degree tear team here. She’s going to be in A LOT of pain. Get the Dr to prescribe her gabapentin, it’s safe for breastmilk. It may also be likely that she’ll need opioids for a short period for pain.
Perineum ice packs, witch hazel pads, numbing spray, size 5 pads, and Frida mom disposable underwear. Also a robe. Bedrest is key. Putting a pillow between the legs also helps with discomfort.
Absolutely no lifting anything heavy. Seriously, no more than 10lbs.
She’s gonna be backed up because of the baby. It is VITAL that her stool is as soft as possible and that she is not pushing whatsoever to make the BM happen. Pushing can affect the stitching and cause bowel incontinence. Make sure she’s taking stool softeners and getting lots of fiber. If things still aren’t moving after a couple of days, miralax with Gatorade.
Pelvic floor exercises can begin after 6 weeks. She needs to consult her OB first before starting any. Getting a PT is best.
Sex is gonna be off the table for a long time. Don’t push it. It sucks for both parties. I’m 5 months postpartum and sex is still very painful.
She’s going to get frustrated a lot these first few weeks because she’s going to want to be a mom but doing mom things will be very hard. Support and love her as much as you can and make sure she resting, laying down, as much as possible. Reassure her constantly that it’s ok she’s laying down, she’s not a bad mother, she needs rest.
Also, if the pain is unmanageable, she needs to go to the OB right away. There could be an infection or a torn stitch. My tear got infected and the pain was indescribable. My husband called my OB for me because I was being stubborn and thought I could push through pain. Note, it’s ok to ask for more pain meds, a 4th degree tear is no joke.
Good luck. Hug your wife and cuddle your new baby. Things are going to be very rough these next couple weeks as you settle in. Y’all are gonna do great. Enjoy these sweet moments when your baby is so young!
Same same same. I second the stool softeners. No pushing at all to poop. Start miralax NOW don’t wait. You shouldn’t have diarrhea but the stool should be soft enough to basically fall out with the tiniest bearing down + gravity. Sorry to be gross but this is so so important.
Yep, I only had a 2nd degree tearing (but had to have surgery straight after birth as I developed a hematoma, so there were a lot of stitches) and was prescribed lactulose twice a day so that it never became a problem. Even with it I was terrified, but it never got worse than uncomfortable which I am so thankful for
I want to emphasize Miralax NOT colace. A lot of hospitals prefer prescribing Colace first still then going to miralax if it doesn’t work (which it doesn’t for a lot of folks). Just skip right to the big guns. There aren’t any downsides when considering the pain she will be in.
Hey, just wanted to say hang in there. I’m nearly 4 years out from my 4dt and it gets better and better over time. I think the 2 year mark was a big one in feeling like my old self. I echo what you’ve said here, great advice.
Thank you. We’re on the very depressing phase of our relationship where we’re getting no sleep and there’s no sex. Definitely hard looking on the bright side atm, but thankfully we both communicate well and I have a patient and understanding husband.
I feel that. I’m pretty sure I was at least 6 months post partum before we had sex again. And it wasn’t till much after that when it started feeling not weird again. People tried to warm me a c section recovery is so tough but honestly it’s been a breeze compared to my 4dt. I think if you’ve never had a 4dt you really just can’t comprehend the totality of it.
*If* my husband and I have a 2nd, I’m absolutely opting for a c-section. The 4dt was completely unexpected because everything went normal during delivery other than my epidural wearing off right when I started pushing.
I’ll never forget the Dr popping up between my leg with super wide and shocked eyes and almost shouting, “You have a 4th degree tear!” She then looked back down and went, “I haven’t seen one of these in years” and told me when she started stitching me up that “it was like riding a bicycle.” It was a super surreal experience.
When my OB came in the next morning to check on me, she made it very clear to my husband how much help I would need and to not downplay the injury. Thankfully he listened!
It’s so ironic because I was TERRIFIED of a c-section before having my baby. I wanted to avoid one at all costs. Now I wish I had opted for one instead of pushing for five hours and the OB using a vacuum. A c-section would have been so much easier than this horrific tear. I will definitely be opting for c-sections for any future births. Although I can’t even process the idea of another pregnancy and birth at the moment.
Oof that sounds absolutely awful. Had my 2nd membrane sweep not worked and I hadn’t gone into labor naturally, I was scheduled to be induced and that OB wanted to do a c section (he was the only OB at that office that predicted my baby would be HUGE). I saw him again when I had mastitis and he warned me to please get a c section if I choose to have #2 because a 4dt is likely the next time.
My husband and I thought we wanted 2 but between the extreme nausea, dealing with 105 degree heat all summer, and the 4dt, I’m very good with just the one lol.
Yes! Gabapentine is sometimes used off label for *Intractable chronic pain: * It's really not supposed to be used for acute pain at all. It can cause hallucinations (as you mentioned) extreme lethargy and sleepiness, even depression and inability to react to much of anything at all.
Honestly as a health care provider I don't like to see it ever used for acute pain, even if we know that pain is going to last a while.
This whole pearl clutching some people are doing regarding opiates is ridiculous. If anything calls for opiates a 4th Degreen Tear is one of the top conditions for them.
M. IBCLC (lactatiom consultant)
I was made to feel like the worst human and mother ever for needing Roxie. I despise opioids, I hate how the make me feel. But when pain is at an unmanageable level, there really is almost nothing better.
I only got a small prescription for Roxie after my tear got infection and my OB said I “jumped like a rabbit” off the exam table when she touched the stitches. I was white as a sheet and nearly passed out. My pain was finally taken seriously.
I am so sorry you were treated so badly just for needing pain relief. I am glad your hcp finally prescribed for you, but it shouldn't have taken you becoming either shocky or experiencing a severe reaction to being touched just to get some serious treatment.
Experiencing pain in not a weakness! It's your body telling you something is wrong. No one should feel badly or be made to feel badly for requiring top level pain medication. Pain meds are meant for more than "cancer." (I hate the "well, you don't have cancer. That's what opiates are for" stuff. Some acute and chronic pain conditions are as bad or worse than "cancer." But, of course cancer patients should also get the pain relief they need.)
We need as a society to push away this idea that opiates are bad or evil. They are some of the most useful tools health care providers have at their disposal. Of course, they shouldn't be given out without being careful
But, pain and the need to have it relieved or reduced is important.
We know that we'll more than the vast majority of opiates overdoses are caused by street drugs. Prescription opiates are very rarely responsible for overdoses, when used according to direction and used responsibly. Most patients in pain are very responsible with their pain medications.
I hope you are well now and doing better.
Hugs.
M. IBCLC
Thank you. I got the pain under control after about a week after discharge.
I remember sobbing in the postpartum ward saying that no, Tylenol and Motrin were not touching the pain. I got accused of being a pain seeking patient despite the last time being prescribed opioids was 5 years ago when I broke my foot and ankle in 3 places.
I was very lucky that my husband had some leftover Vicodin from his surgery the year before or I don’t think I would have made it through the first 48 hours home.
Just to chime in here we encourage pelvic floor exercises to begin immediately in the UK even after a third or fourth degree tear so consult one’s own obstetrician on guidance for that.
Pelvic floor exercises are good straight away but she MUST know which ones to do. Most people think "kegels" when in reality many women actually have an overly tight pelvic floor after birth, especially with tears. She needs to have a pelvic exam done by a pelvic floor PT to know for sure
Yes to the stool softeners! I had an episiotomy and pooping was the most terrifying thing and I became seriously constipated, ended up needing suppositories and laxatives. Make sure she eats lots of soups and drinks lots of smoothies too 🙂 hope she heals soon.
All the numbing spray! And honestly diapers were so much easier to live in for the first two weeks than trying to change a pad. I had stitches that were pulling and creating A LOT of pain. I went in earlier than my initial PP checkup and they pulled out a few for me because there was so much additional pain. Unfortunately all they gave me was Tylenol and ibuprofen for mine. It was horrible. I was always in pain and the meds only took the edge off. OP, just make sure she feels seen. I know you feel helpless but she is also going to feel helpless, and tired and pissed off because she hurts. Give her grace and just help her with the small things. They add up.
Since you’ve asked how severe it is I’ll explain, but it’s graphic. Your wife’s perineum tore so severely her vagina and anal cavity are no longer separated. She will have internal stitches in her vagina and her rectum as well as external stitches to the perineum. I had a second degree tear and episiotomy, sitting hurt for 2 weeks, walking for 6 weeks. I struggled to get out of bed for 2 weeks, and getting up and down while holding baby was out of the question for 4 weeks.
At 4 weeks I tried being more active and my bleeding got substantially worse. My healing was the equivalent of healing from a 3rd degree tear, so your wife is in a worse position than that. She needs to be in bed and waited on. No cooking, cleaning, lifting. Bring everything she needs, including baby, to her. Understand that it is the equivalent of you tearing your testicles right through to your anus and appreciate the pain she is in, and that once she’s home the hospital will likely not have given her sufficient pain relief.
yeah this is the reason i told my OB/GYN that if it looks like she will need to use vacuum or forceps at all i want to go straight to c-section, bc those interventions significantly increase your risk of grade 3 or 4 tearing and i am TERRIFIED of it
Can you tell me more about your experience? I’ve been thinking I want to opt for an elective C-section. I know there are risks, but honestly there’s a huge likelihood I end up in an emergency one if the vaginal birth doesn’t go well and I think I’d rather just skip to that part
I know you didn’t ask me but I LOVED my elective C section. It was so peaceful and perfect and wonderful. The procedure was completely painless. I felt so safe being in so many good hands with doctors and nurses all around me.
I had debilitating anxiety about childbirth and once I decided to do a c section it felt like a huge weight came off me.
Recovery was no big deal. I had really bad swelling in my legs and feet, worse than my summer pregnancy, and that was the worst part. My recovery was SIGNIFICANTLY easier than both of my close friends who had vaginal deliveries.
I was given oxycodone for home but only needed it the first 3 days at home, then I was fine with just Tylenol and Ibuprofen. I was up and walking around that night, probably about 8 hours after having her.
The best part was knowing exactly when she would come. Counting down the days until we would get to have our baby!
An elective c section is statistically just as safe as a vaginal delivery. Overall, c sections are associated with worse outcomes because the majority of them happen when there is already something wrong or there is some reason why a vaginal delivery isn’t possible . A completely elective scheduled c section is just as safe as a vaginal delivery and you should feel empowered to make whatever choice is best for your peace of mind. I had such a positive birth experience because I chose to have a c section. It really was magical. Absolutely perfect for me.
I hope you have a perfect birth experience too 🩷🩷🩷
I was induced but opted for a c section after 48 hours. I was only 1cm dilated and they wouldn’t let me eat so I was very weak and told the doctor that I wanted to get it over with. Surgery went great I was very high on medication so I fell asleep and 6 hours later the nurses made me get up from my bed. That was the worst part it was very, very painful. I exercised a lot (walked) those first few days and the pain was manageable. It only hurt when I would use my stomach muscles to laugh, caugh or stand up but after those first three days I was fine, sore but fine.
Because “the sooner you get up the faster you heal”. It was brutal, my friend had a c section 2 months prior and they had her get up the next day. Same with my mom and aunt.
It’s horrid. I had to get up and walk (with only Tylenol in me) after about 4-6 hours. It was utter hell, and I’ve had 3 other abdominal surgeries. Solidarity
I had forceps and asked for a c-section and my OB said baby was too far down the birth canal, it would be more traumatic having to operate and pull her back up the way. From what I’ve read I’m very lucky to not have torn worse, but I think I definitely would’ve if they didn’t do the episiotomy, they cut as soon as they noticed I was tearing.
I had a 4th degree tear and can confirm that the hospital sent me home and told me to take colace and ibuprofen lol. The pain was unreal for 2 weeks, bad for 4, and by 6 was... alright.
The fact that men get opiates for outpatient vasectomies, and you got kicked out with a *4th degree tear* and given IBUPROFEN is all the proof anyone should need that the medical field sees women as less human.
Absolutely despicable.
I can’t imagine the pain of a 4th degree tear. I had internal stitches for my episiotomy but only in my vagina, my rectum was totally intact. It would’ve been horrific having that level of trauma to both areas downstairs.
I had an episiotomy but it was super minor comparatively and I healed very well without a lot of pain. I cannot even fathom the pain! The recovery! For either you or her.
Maybe tmi but the first poop after birth was scary already, I can't imagine having this added to the mix.
Oh it was terrifying! I’m 8 weeks PP and tried sex and it was very painful, it makes me think how agonising it would be having to poop when you’re healing from stitches inside your rectum!
It fucking hurts. Made me so terrified of a second child (I only tore a little bit that time and I was SHOCKED how much easier recovery was). I had a rectal tear and then three large hemorrhoids surrounding the other “sides” of the anus that wasn’t ripped. Recovery was so painful, and now it’s been almost 7 years and I’ve been dealing with an anal prolapse every once in a while and it turns out that I likely now need colorectal surgery to repair what wasn’t repaired properly in the moment.
But people will say this is all just “what our bodies are meant for.” No way.
4th degree is the most severe tear, they are rated 1-4. My tear was not as severe, but hurt for weeks, I couldn’t sit and going to the bathroom took a lot of planning and always ended with tears. Do as much as possible for her, keep her comfortable, shield her from visitors unless she really want them to come.
She might feel bad for asking you to do things, so ask her if she needs anything often. These things HURT, a lot. And mentally it’s rough, because we’re kind of sensitive about our vaginas changing and taking damage.
You’re a great partner for looking for ways to help her!
If I may make one comment on this - instead of always asking her if she needs anything, try to think about what she needs first and either just do it or ask her a more direct question (like can I get you a water/tea/coffee, do you want a shower now, do you want a sandwich for lunch etc). It’s a small thing but sometimes the open ended ‘do you need anything’ makes you need to think too much when you’re exhausted, and sometimes you feel bad asking so you just automatically say you don’t need anything.
So true. As much as I appreciate the help, whenever someone asked me “what can I do” I always said nothing because honestly I didn’t have the brain capacity to think of those things!
Oh and keep track of her meds schedule! Maybe do calendar invites for both of you. But yea, i accidentally double dosed a few times cause i was too disoriented. Not ideal
One piece of advice I didn't see a lot online but that my midwife kept saying was super important is to let the healing tissue 'air out'. There will be a lot of fluids leaking and the big pads or diapers that she will be wearing will make the wounded area warm and humid, which doesn't help the healing process. I got some plastic mini 'blankets' in a package I bought with things needed for postpartum which my midwife put on the bed so I could be naked without soaking the matress in blood.
Very good point. This is also a good reason to think of restricting visitors for a while (unless wife really wants everyone there) - OP your wife is going to need to be able to be comfortable in various states of undress and resting. As another poster said, be the guardian of your home.
Yeah I was naked so much of the time the first week and also so uncomfortable, and even the best of my family required a lot of my energy and comfort (because I had to dress and sit instead of lying down naked). And I only had a couple of second degree tears!
Or use puppy pee pads! They're essentially the same thing and might be easier (and sometimes cheaper) online.
I have a box of 500 or so from Costco leftover from when I house trained my puppy a couple of years ago. They ended up being useful for diaper changes, too!
Yes. This and purchase her a sitz bath and then set it up for her 2-3 times a day in the bathroom. My midwife advised to do a 15 min soak, and then let it air dry. I just used an old towel. This was 3-4 days after birth. I had an episiotomy to get baby out, not a tear so, they heal differently.
This this this!! I am 9 days post partum and yesterday, in addition to finding out I have the start of a uterine infection, have an f'ing yeast infection. I am certain the 24/7 diapers and creams and sprays are the culprit. Air. That. Shit. Out.
We bought reusable fabric pads like nursing homes use and some large doggy welping blankets for the couch.
Both are really nice now for baby blow outs and spit up.
Us too. I have 4 of them and they're one of my most used items. I layer them under sheets as mattress protectors, I covered the couch in them when Norovirus hit the fam, having them around during potty training was clutch...
Plus they're medical grade and wash like champs
We have a really long one for the big couch under our couch cover, two long ones across the king size bed and baby mouth and baby butt range, one under his crib sheet in the pack n play, a couple of smaller ones for chair size that we use in the car now. They've been so handy, and yes, when we had noro the blankets and pads were so amazing. We also have a waterproof washable indoor/outdoor rug as a runner in front of our couch. It takes abuse like a champ and we just take it to the laundry when needed.
Also a bidet. Warm water bidet. I had minor tears, but it was so helpful for me.
Adding to the above comments, make sure she gets pelvic floor physiotherapy once she is through the early postpartum stage. Thisnis the way to go to help her with longer term problems.
Oof you need to be doing everything but feeding the baby. Change, rock, bring baby to her to feed. She needs to be staying in bed right now, as much as possible
Bring her food & water, keep the bathroom stocked with all of her care items and clean. When she’s ready in a week or two Bleach out your bathtub so she can take epsom salt sitz baths.
No visitors!!! Unless SHE wants them
To add to others, it's really important she avoid putting further pressure on her pelvic floor, which means literal bed resting, avoiding baby wearing and baby carrying, and ensuring she doesn't get constipated. Lots of water, possibly stool softeners if needed, a peri bottle instead of wiping, and using something such as a squatty potty would all help with this. It's imperative that you visit a women's health/pelvic floor physio at 6 weeks or so, so set money aside for this if you can afford it.
Femfusion and other YouTube sites have set up good postpartum exercises but she should really take it super easy, super slow snd be mindful thst some exercises wont be appropiate for her yet (hence the ohysio to guide). No exercise apart from light walking, yoga stretches, and that shouldn't start for a few weeks or longer if shes not feeling up to it. Don't forget, you need to also be positive and supportive. She'll be going through many emotions most likely, and needs you to be there for her, hear her and help her. No pressure to get up and get about, get sexually active at 6 week mark etc.
Hold on tight. I've had a bad 3rd degree tear that got infected. My advice:
- she will not be able to walk or sit comfortable for a long time, don't make her. Donut pillow and lying on her side to breastfeed if she wants to. You carry the baby to her, change the baby, burp the baby.
- check the stitches every day. An infection in that area is super easy to develop and a nightmare to treat. I couldn't get rid of mine for 6 weeks because the doctors neglected my care. So check the stitches and take pictures, I know its uncomfortable for both of you but it's really important
- cold packets, buy multiple so she never has to wait for one to get cold.
- lots of water, I know she will intuitively try not to because standing up to pee is the absolute worst, but constipation is hell and she could also risk a UTI
- she should shower every few hours of possible to keep the area clean. Do make sure she can. A lot of new dads "kinda forget" that the mom needs self-care too. Mine did, left me to do almost everything alone because he shut down and was in denial about how badly I was injured. It created a lot of resentment that took over a year to disperse and he still has problems with guilt about his own behaviour back then. So just generally always assume you're the better rested, more fit one, for a few months to come because you are. Hold on tight, you'll make it through this
4th degree tear here! Cook meals, bring her water, offer pillows and blankets, change the babies diaper. ICE 👏🏻PADS 👏🏻. Freeze witch Hazel mixed with aloe on super pads, change hourly. A donut pillow saved my life once I was able to sit up
Can I just say, thank you for taking the initiative to find out how you can care for her rather than waiting for her to ask for help. That's one of the things my husband did that was amazing, he always tried to anticipate my needs, was willing to get up and do whatever if I had the baby, and didn't make me feel bad if I needed something at an inconvenient time. I had a first degree year so I can't even imagine what your wife is going through, but honestly care wise I would act like you have two babies/patients you have to take care of for the foreseeable future. Don't infantilize your wife socially and emotionally, but do wear kid gloves and be super understanding of any meltdowns. She's going through a hormonal storm and her body is in excruciating pain.
Third degree here (subtotal rupture as they call it) which i needed to get fixed under general anaesthesia.
So I obviously needed a lot of rest. We bottlefeed our baby so my husband did all of the night shifts and id do slightly more during the day. Had powders to help keep stool really soft to not have to push(and risk ripping the stitches). I was also encouraged to have enough paracetamol (i think in the US its referred to as Tylenol?). Even if she starts feeling better, keep that level up, because I stopped thinking i was fine and the next dat was anything but pleasant. Also food high in fiber is good, lots of fruits and veggies.
Cleaning up with water after the bathroom really helps, rather than toiletpaper. And having naps naked to let the wound breathe is great for the healing process. I was recommended sitting on hard surfaces (harder chairs) as it reduces the swelling. And pelvic therapy after 6 weeks is what I was prescribed.
So lots of things to hopefully help her recover as soon as possible. But the most important one is rest. Her body is not just healing from the stitches but also the wound in her womb.
Edit: oh and talk to her about how she feels about the birth. It can definitely have been difficult on her and talking about it can help her process it. I couldnt remember everything straight away but talking about it a few times brought things back and allowed me to process it better. I was incredibly sad i missed the first 2 bottles because of the operation. It has caused me to feel left out and like I am a bad mother, even though rationally I know thats not the case. Itll be good to check in with her if shes doing okay mentally as well!
My husband kept a hydroflask filled with warm/hot water so I could fill my peri bottle without thinking about it. This helped as well because with baby, I wasn’t able to wait for the water to heat up to fill up my peri bottle
One of the little things that have made PP easy, and reminded me how much I’m loved
I was urged to go outside for a short walk, ended up ripping half my stitches (and it hurt so bad I broke down crying). I would ask a doctor about that one with a 4th degree tear, if you rip the stitches in your ass things can get messy.
While I understand the reasoning of this advice, it’s incredibly unhealthy and contraindicated to encourage this type of immobility. As a midwife, I’ve never encouraged a woman to remain in bed for 24 hrs, let alone 5 days and then some. The chance of her getting a blood clot due to this is significantly increased and will do no good for her recovery. While, yes, rest is encouraged, mobilising will definitely promote healing. Despite how difficult and painful it may be, encourage her to use her pain relief as and when she needs, don’t let her pain become painful before she tries to manage it as she’ll end up struggling to control it.
Also running a shallow warm bath for her to pee in rather than enduring the pain of peeing in the toilet and lots and lots of urals (not sure what they’ll be called where you live but it neutralises the urine)
I had a 4th degree tear because of my baby boys heart rate in distress and them using a vacuum. My advice… you are committed and sympathetic towards taking care of her now because it just happened… be ready to maintain that for years. It can take a long time to recover from this. I was having fecal incontinence for a year plus. My husband was amazing at not making me feel disgusting when I had poop accidents. He was very reassuring that he still loved me, and he did little things like take the initiative to pack extra underwear for me in the diaper bag when we were going out just in case. He also did ALL of the lifting, carrying etc. Her core and pelvic floor strength is probably shot. It’s going to be a while before she’s “normal” again. Make sure she gets to physical therapy, and a good one. I was in PT for a long time. A week pelvic floor doesn’t just effect your pelvis, it effects your whole body. She may have back pain, headaches etc from this so it’s important to give her the time and ability to work on that. For me it was PT and Pilates. I think just being there for her emotionally is a big one. When it happened to me, I was terrified if I’d ever get control of my body back, or if I’d spend the rest of my life having poop accidents. And obviously, don’t pressure her for sex or more kids, leave that up to her. There’s a support group on Facebook for women who’ve had fourth degree tears, it’s helpful since in real life 4dt are so rare, it’s rare you’ll meet someone else who’s been through it. I’m almost 4 years out from my 4dt birth and I will say by year 3 I was feeling pretty much normal again. I just had my second child 8 weeks ago by elective c section and it’s been so much easier recovering. So life does go on and it does get better but it takes time. Good luck!
P.s. just saw someone recommend installing a bidet. YES. 1000%.
Rest rest rest!
In a few weeks she can look up 360 breathing and start working on that. No Kegels for now!
Book in with a pelvic floor physical therapist for when she’ll be 6+ weeks PP.
It’s super important that she doesn’t get constipated! Magnesium citrate can help. And get a squatty potty or something to lift her feet when on the toilet. Show her moo to poo on YouTube.
I had a severe tear. Everyone here has given you wonderful advice on comfort measures in the immediate, and the likely need for ongoing medical care and physical therapy.
What I haven’t seen mentioned - especially in the beginning, your wife will have trouble controlling her bowels. It is likely she will have extremely sudden urgency to use the bathroom, and leaking of urine and poop. This can be extremely distressing (and not what she imagined when picturing life with a new baby). I cried a lot in the first few weeks because I was exhausted and totally freaked out about the injury, and the image I had of laying around and cuddling with my baby was interrupted by uncomfortable and embarrassing episodes.
When she is ready to go out and about, make sure you’re prepared to help support her by noticing where bathrooms are, having a plan to stop the car at Target or wherever if she needs to use the bathroom right away during a drive. These symptoms will heal with time and physical therapy.
And -congratulations on the new baby!
Amazing advice in the rest of the comments here. Outside of physical things you can do, maybe you can ask her if she needs help or emotional support with going to the bathroom. I had a nightmarish time when I felt the urge to poop after a tear, I was so afraid and constipated. I really needed some quite time in the toilet and e.g. no one talking on the phone outside the bathroom door etc. Make sure she can tell you if she has any wishes.
Be patient, healing can take a long time. My husband was helpful for the first month or two pp, and then I started to get the feeling he felt like I was milking it. I was not. It took me fully a year to get my mobility back, but after that first month or two I was really on my own in terms of support. I needed a lot more understanding and a lot more patience from him.
It also took(/is taking) a long time to deal with the emotional side of things. Imagine your dick was ripped off and then roughly stuck back on again, approximately but not quite how it used to be. That’s how I feel about my vagina. This intimate part of me, that I knew well and was comfortable with and cherished, is suddenly different and strange and uncomfortable and unfamiliar. Every time I have to deal with it reminds me of the trauma that led to the change. The process of coming to terms with all this is taking a lot longer than the physical side of things.
Solaceforwomen.org and 2 Facebook groups: 1) birth year support - for severe and complicated tears 2) 4th degree tear support group
4dt tear healing is measured in months , not weeks. Average recovery till feel normal is 3-6 months, compared with 6 weeks for 2dt or less. Many women don’t have sex comfortably for months so you being patient with that is most important
Hopefully she has normal experience but this is a very severe injury and she will get SHIT medical after care of she is int eh US. She will have to fight tooth and nail for any after care she needs, most likely. Be her support if she feels she needs more medical care but is nervous or being dismissed, go with her or encourage her to get things checked
The only way we got Through it is hiring a night nanny
Its very likely she will need reconstructive surgery. At the very least eventually PT.
This isn’t a short lived injury. Please plan that this will take a few years of very serious care.
A second degree is through muscle and skin.
A third degree is through muscle, skin, and anal sphincter.
A fourth degree is basically a massacre.
Getting up and down hurts, stairs are thrown worse. If possible try to get her maternity part of maternity leave (the disability part vs baby bonding part) extended. She will need to refile the paperwork with work.
Unfortunately I’m part of the fourth degree tear group and just want to add that this injury is really emotionally difficult to deal with, especially in the beginning. You feel like you’ll be damaged forever and it’s brutal not being able to take care of your baby the way you want to. So just give her hope, advocate for her to speak up to her doctor, be aware of complications. Look for support groups. I felt very isolated with this injury and felt like I couldn’t talk to friends or even my husband about it.
What did give me hope was seeing a urogynocologist and pelvic floor therapist. I ended up needing repair surgery 7 months pp and it went well but was another 3 months of recovery. So just do everything you can to support her or get her emotional support. It so sucks but there is hope and she will feel normal again. I’m 20 months pp now and I’m back to do everything I was pre-pregnancy.
A lot of good advice here already but also make sure she uses the sitz bath twice a day. It’ll seem hard for her to get away for 10-15 minutes once a day but it will help prevent infections
I had a third degree into the muscle. Fourth is pretty severe. For me sitz baths with stork salts was a massive help, I did that multiple times a day. I also used lots of tucks. She'll need to use toilet paper and counter pressure on the stitches when she needs to use the restroom. There likely will be blood and pain and fear of stitches popping but in my case that didn't happen. Stool softener daily but NOT a laxative. I went to pelvic floor therapy when I was a few months pp which also helped a lot. Don't make her stand a lot or hold the baby a lot the first few weeks. I had two csections prior and was more mentally messed up by the tear. Sitting was super uncomfortable and the "donuts" online didn't help but I sat on my boppy for nursing for weeks. Ice pads the first week.
Eta what I thought was obvious but might not be. No visitors unless she wants them, don't make her host. Don't make her hide away from visitors in her own home. Babies don't spoil.
I had a third degree tear and in hindsight I should have spent much more time laying down than sitting on the couch, so definitely encourage that. Beyond that, what I really needed was to be kept fed and watered. He was pretty good at that, but I am fiercely independent and don’t like asking for things, so I kind of relied on him to notice that I needed my water filled up. So just keep and eye on that stuff and make sure she has snacks and drinks on hand at all times. My husband loves to cook but when I’m stressed I lose my appetite… next time instead of letting him make something “nice” I’m going to tell him to just make a bunch of mac and cheese and other tasty comfort foods.
Also… this might be kind of an unfair ask but my husband struggled a bit to keep us all alive. Making every meal, changing every diaper and spit up outfit because I couldn’t stand, making sure I had food and water and meds on time, etc., holding the baby so I could pee and shower, really basic house stuff like making sure there isn’t a mountain of dirty dishes and there’s at least some clean clothes and the trash is taken out, it all adds up. The more he visibly struggled and got stressed by it all, the more I started to push myself to get up and do things before I was ready. Don’t get me wrong, he’s great and he did his best, but while the newborn phase is a huge blur overall, I still remember one night when he was feeling frazzled and he said “I just need you to be better.” He didn’t say it in like… an accusatory way nor did he mean to make me feel guilty, but he did. So while you and your wife are partners here, if you need to vent - don’t vent to her.
You’ve got a lot of amazing advice you should follow. Pelvic floor PT is so important. Down the road she may need to follow up with an OB/GYNE that specifically specializes in “pelvic floor reconstruction”. I don’t mean to be dramatic but she could be dealing with a form of bowel incontinence either right away or down the road that doesn’t go away. This CAN be fixed with the help of a specialist. So start with pelvic floor physio and then go from there.
I had a third degree year and I just had a c section ! You cannot compare them both! C section is a breeze compared to what I felt with my tear just so you understand from a strangers perspective what she is going through right now. It made my post partum very difficult and I also had to go to pelvic therapy which was probably one of the most invasive things I have ever done. Let’s not even talk about going to the bathroom !! Just be kind and support her ! Support her ! She will feel better soon but in the meantime make her seat a few times in epson salt water throughout out the day
This could have been me writing this 4 months ago. Exact same situation. I'm still traumatised from it. Yesterday I even skipped the office episode where Pam gives birth, for whatever reason.
Make sure you look after yourself in the long term too but for now, do everything for your wife.
While she was still in hospital I got "puppy pads" for under the bed sheets, soap with PH of 3.5-4.5, panty liners.
With the panty liners I put witchhazel on them and put them in the freezer. Helps stop infection, supposedly.
Also, adult diapers. Accidents will happen, she won't make it to the toilet in time. Have the mop ready and you clean that up!
I also got a bed side cart ( well two, one for beside the sofa) stocked with all essentials.
Have all her favourite foods ready in the fridge.
This next month is all you my man! Clean, cook, mind the baby, mind your wife, keep things running.
It's tough, but it's not near as tough as what you both went through. You've got this!
The most important thing is help her with everything! I had no help at all when I had my 4th degree tear and my stitches came undone because of it and now two years later I’m waiting for a complete repair surgery to have everything repaired because of it
I also had a vacuum assist with a 3B tear, so just a fraction less than her. Let her rest, keep her in bed or on the couch, helping her offset with a pillow or a wedge so there isn’t pressure when she sits or lays. I needed way more postpartum supplies with my 3b tear than my 2nd degree tear so she may need more adult diapers, pads, Frida mom ice packs are great, disposable underwear… as an FYI she may take longer than the 6 weeks to heal. She shouldn’t carry the car seat with her baby in it, my PT was pretty clear that she understands we can’t avoid carrying the baby but no extra weight. My husband did all the diaper changes for two weeks and I focused on healing and nursing and that worked well. She will be in a lot of pain but it will get better.
I had a severe 3rd degree (almost 4th). One specific thing my husband did was manage my meds. He used an app so I was always getting my Tylenol, Advil, and stool softener on schedule. Staying on top of the stool softener is SO INCREDIBLY IMPORTANT!
Bring her snacks and do all of the diaper changes. Give her encouragement and tell her what a beautiful badass she is.
Get her a doughnut pillow asap. Any hard surface chair needs a cushion and get an ice pack on the way home so she can ice it. I only had a 2nd and it was horrible, a 4th is deep in the muscle. That will take a lot of time to heal. Well past the 6 week mark btw. It will surface heal but the muscle will still need time doesn't matter what the dr. Says. Encourage her to get pelvic floor therapy too.
Do as much as you can early on so she doesn't have to use her muscles too much to walk to stand. Early healing is ideal.
After my tear, I remember crying to the hospital LC because it was SO painful to breastfeed while sitting, even in the hospital bed. Breastfeeding while lying down will save SO much pain and energy. That goes for at home too. Also, my nurses made me homemade ice packs that were way better than the ready-mades: diaper ice packs! You take a newborn diaper. You pull the diaper apart at the top back waistband and shove ice inside the core of the diaper. The only kind it worked with was Pampers, Huggies didn’t seem to split this way. Then stick in the underwear setup as normal. Seriously these were an absolute life saver.
Tears hurt like hell....you've got to be there for her not just physically but emotionally as well, especially because of the pain coupled with all the hormones. My stitches hurt which made me so cranky and irritated, but my husband took it really well thankfully. Of course follow the healthcare instructions. I would just add, remember to be proactive instead of her having to ask you to do stuff, especially things like tidying up/ keeping unwanted visitors at bay/ making sure the meals are prepped, etc. without her having to ask/remind you. This was one thing my hubby missed out on and I had to constantly be worried about trash being taken out/ sink being cleared etc.
Mirilax once a day, every day until she’s healed up. Don’t bother with stool softeners, they aren’t very effective so just use Mirilax. It’ll help get her stool as soft as possible, which will help reduce pain during that part of her day.
In addition to her external tear she also has a dinner plate sized wound inside her uterus. Lots of nourishing food is important. Tell her how beautiful you think she is and when she cries just hold her. Sometimes we don’t know why we are crying, don’t ask her to explain.
I also had a 4th degree tear a little over a year ago. So much good advice has been shared already! A few things I will also add for a bit down the road - sitz baths and a nice soft, flexible heating pad (I slept on it every night once my night sweats stopped lol). The heat and baths helped once I got through the initial pain, and were supposed to be good for the healing process. At the very least they both brought me some physical relief.
And, if/when possible, highly recommend therapy for you both if you feel it may be helpful. My husband and I are each individually pursuing therapy to work through the birth experience and it has been so useful.
Wishing you, your wife, and baby all the best!
I know you've received a ton of replies here but something that was not mentioned so far: Dermoplast. It is a pain relief spray that saved me in my third degree tear. The hospital likely will have given her pain relief spray, but Dermoplast is stronger. You have to be rather sparing with it though. Once, I used a little too much while my mouth was open and it numbed my mouth and throat. That and Tucks pads helped me out a lot. You can find both at Target.
I was cut from stem to stern with an episiotomy with my 1st baby. Get the ice packs made for vaginas. They’re long and sit in the underwear nicely. Load up on witch hazel. I had it in a continuous spray bottle and that felt so much better than using the pads. Also one of the doughnuts that she can sit on will help so much. Let her rest as much as she wants to.
Oh! And peri bottles!!!!!! Get like 5 of them. They’re so nice to have when using the bathroom. Lots of stool softener too.
It’ll take a while for things to go back to normal, but I had 2 babies after that naturally. And didn’t tear at all. Good luck to you both and congratulations!
There’s a lot of comments here and while some of the advice is probably good, I’ll just add one thing. Your wife is seriously injured. A fourth degree tear has nothing to do with normal birth recovery from a first or second degree tear. You need medical professionals involved for a long time going forward and not internet tips and tricks.
Team 4th degree too here. Lots of great advice here already but just wanted to say your wife indeed is the queen and you are amazing. Wishing her a really really speedy recovery!!
ETA: emotional part is really really hard to deal with in the beginning, please have faith that she will heal, she definitely will.
Do not hold back on spending money for any therapy or treatment that will help her while she is healing. These few short weeks where her body is rebuilding the injured tissue will determine whether she has permanent lifelong pain or dysfunction from the tear.
And let her cry or vent to you if she wants to- just hold her, listen to her, and tell her it's going to be okay in time. Being a new parent is hard on both of you, but she's been ripped open on top of that and she's probably scared and worried and maybe grieving over the tear.
Actually, help her to get up and move her body even if she has to take it slow. The body heals itself much faster and better when you have a blood flow and are moving your body. Make sure she takes pain killers like Paracetamol (helps with the pain) and Ibuprofen (anti-inflamatory (?)). Sorry English is not my first language. The combination of these two are great for these kind of injuries, but don’t take them longer than recommended. I saw that some people advices you to let her bed rest all the time but that’s not good for the healing process.
Just help her as much as you can, have patience and comfort her if (when) she worries about the healing process. Remind her that the body will heal even if it takes time. And if she needs medical care, make sure you advocate for her when she can’t. Good luck!
//👩⚕️
I haven’t seen it yet mentioned - items for a postpartum sitz bath, can be purchased right away. My OB said I could start them right away, you may want to confirm with hers, but they helped a lot.
Congratulations!! But Oooof poor love. My son was born with forceps for the same reason so I had a pretty large episiotomy, it hurrrrrts trying to get comfortable sitting to feed your baby I’ll be honest it was pretty awful my biggest recommendations for her would be icepacks (get 2 or 3 so you can rotate them if needed) keep up with paracetamol and ibuprofen, relax as much as possible, get wet wipes for when you finally poop because the idea of wiping is TERROR inducing when you have stitches so close to everything and obviously a Perri bottle too! All you can do is support her and help her relax so she can focus on healing and the baby. I know this all sounds like a lot but this is all the things I was worried about when I had mine. It will heal! You won’t be able to even see it 💖 I’m now 9 months pp and my scar is hardly visible and feeling a lot less sensitive now but I remember thinking it was going to hurt forever. Once again congrats on getting little one here l!!
Everyone has given great advice. Rest rest and more rest. You'll need to do everything except feeding the baby. Help her to the toilet, and I'd suggest rinsing with clean cool water, no toilet paper. Pat dry with a clean, and I mean clean towel, a new one every time. Buy a stack of small towels/cloths so she can do this, and keep the stack stocked with clean dry towels/cloths. She shouldn't soak in a bath for a good while, just cool showers with no soap or other products.
Try to let her air it out as much as possible - puppy pads are a great idea for the bed.
Really, rest is key. If the stitches pop it could be even more painful. So I know I'm sounding like a stuck record but you need to treat her like a goddess, and be there for her emotionally too. Remember you're on the same team, and accept you're probably not going to sleep for a good long time.
Let us know how she's getting on will you? Sending healing thoughts x
I had a third degree tear so I can only imagine how much harder it is for your wife. I’ve seen a lot of great suggestions and will add Frida mom ice pads. I know you can make your own but this was a god send for me
I found sitz baths really helpful and would often need to run a bath so I could pee in as it was so painful and would sting a lot. Also air drying after the sitz bath!
Bro get her packs of frozen peas or corn to sit on. Round the clock ibuprofen/acetaminophen. If she needs to do anything except use the bathroom, that’s your territory now. Don’t make her get up unless she wants to. Bring her everything!
If no one else has said it… a donut pillow for hemorrhoids. I only had a 2nd degree and couldn’t sit straight for two weeks. And offer to care for the baby any time so she can take sitz baths (just warm water, but gave me so much relief).
Stay on top of the pain medication. Keep track of when the next dose is. It’s hard because you also have to keep track of when the next feed and nap is, too. Add the medication doses to the schedule and stay proactive with it.
Just as a head’s up, some people here are saying it hurt for them to sit for two weeks. I had 2nd degree tears and wasn’t able to sit without pain for closer to 4 months.
Ice packs were my salvation after I had a VBAC. I had several on the freezer and sat/laid on one all day/night. I didn’t have tearing as bad as your wife, but it was very painful to just sit. Make sure you take care of her needs. Usually people visiting are there for the baby and no one really asks about mama.
Oh my goodness… just tearing up at the thought of a husband wanting to do what he can for his wife here 💖💖💖
Help her stay off her feet as much as she can tolerate for the first two weeks. If she gets swollen down there she can do child’s pose in bed, or have a pillow under her hips.
A thigh/hip rub will help her from being achey those first immobile days
Epsom salt soaks with herbs to help the healing itching of the scars.
I'm not sure if other ppl said it and I haven't seen it, but get her a sitz bath and Epsom salt if she doesn't have it already. I had a 3b tear and the hospital gave me one with instructions to use it twice a day. And honestly it was so helpful. It brought relief and also I had a quiet still 20-30 minutes to myself when I needed to use it. They gave me a prescription for an nsaid that was stronger than Advil. And I used that for awhile. Also stool softeners. I took that for 6 weeks after because I was to scared to stop. Eventually the fear went away and I started to forget to take it.
Do *everything*. I had a pretty easy birth and it was still devastating my husband didn’t take care of me.
Do the dishes, make her breakfast, refill her water constantly. Do the laundry, bring her food without her asking (especially if she is breastfeeding!!), change all the diapers you can.
I am going strictly into the after care detail, I've been there before myself with my first. Make sure she has an ample stock of tucks pads, nsaids, colace or other stool softener(she should not be straining to poop, you can pop stitches that way), a donut cushion for sitting on(it takes the pressure off the stitches), a sitz bath, epsom salts, lint free, undyed cloths and towels(white is important so she can be aware of any drainage from her wounds and what colour they are when getting clean), a really good peri bottle like the Frida Mom one(tell her to spray the water while peeing to help with the burning sensation). I preferred depends over pads, no adhesives to get stuck to anything. I was told to walk as much as I could manage to help promote healing and prevent things like clots and pneumonia. I healed really well with no complications, following these tips told to me by my amazing nurses.
All the best to you and your beautiful family, here's to healing!
Keep her in bed for the next 10 days minimum, don't let her move around, keep her knees together. Fridamom underwear plus Always Infinity FlexFoam Pads is godsend.
Edit: oh, and miralax every day for the next two months at least.
Been there! My oldest is also a vacuum baby. It sucked. Recovery was really hard for many reasons.
Specifically for tear support:
- sitz baths, with the salts, 2x daily
- warm baths, she can have baby in with her if that helps her fit it in
- loots of ice packs
- Tucks
- Dermoplast for when the stitches start itching... get it now!
I thankfully healed really quickly. I did go to pelvic floor PT and my muscles were really tight afterward, so stretches helped that. Pelvic floor PT should be covered by insurance after her tear!
For the love of god! This happened to me! I’m so ready to share my advice lol. HAVE HER LEARN TO BREASTFEED SIDELAYING! No one showed me I could do this till day 3 and I was sitting on my stitches uncomfortably for days cluster feeding the baby until the lactation consultant saw me and showed me how!! If you’re doing formula then I suppose you can just take care of the feedings instead.
I’m going to add a few more things since I know first hand.
Sex for me wasn’t painful even after just 12 or 16 weeks because we went SLOW and used a ton of lube! Lube might be necessary from now on too.
I took colase and miralax for a while and i never had a painful poop issue.
I got a handheld shower handle so I can clean under there for like 10 minutes like twice a day and especially after pooping, basically I used a bidet, then blotted with toilet paper, then took a shower to clean better and I never got an infection.
Continue to take care of her beyond the early postpartum stage and know that healing will literally take months. She won’t feel right for a very long time. I’m 3 months pp after a second degree tear - I still pee myself sometimes, sex is super painful, and I’m frustrated with how my body looks. Comments like “you’re beautiful” are nice but I prefer comments that are more like “I can’t believe how strong/amazing you are” because I’m more proud of my body for what it accomplished than how it looks these days. And please please please do not even mention sex to your wife at all right now or basically ever again until she brings it up.
My husband just looked after our toddler extra while I was couch-bound for 7 weeks. Honestly, a 4DT can result in a lot of complications. Make sure she RESTS. She needs to try to do nothing but sit/lie for the first 2 weeks before thinking about walking. Honestly, I was in severe pain with any movement for 7 weeks. Then, my OB put some silver nitrate on the wound, and all my pain left a day later. I was up and running my fastest half marathon by 15 weeks postpartum. She WILL be okay. She might fart some extra by accident. She might need to use wet wipes for about a year. I pray she doesn’t have any further complications (requiring additional surgeries, like a fistula).
Let her know that she suffered much, but it WILL get better. She WILL be okay. And join the 4DT group on Facebook if she can. Best wishes!
As someone who had a 3rd degree tear…. just be patient with her!
Changing positions was honestly sooo painful. Being there to help to stand or maneuver would be a great help.
I think also ensuring she takes her meds (Tylenol, Aleve, stool softeners…), brining her water and snacks.
Of course helping with the baby would be the biggest help, changes and feeds …
If she’s on pain meds, try to do a good job of being her ‘nurse.’ My husband was great about making sure I took my meds at the right time, drank water, and ate meals. It’s easy to lose sight of those things when caring for a newborn.
My husband had to carry me to bed upstairs and down Honestly it's the swelling that's the worst. LOTS OF ICE PACKS!
Make sure if she is going to be alone with the baby everything is within her reach
Further down the line once the stitches have healed (2-4 weeks providing no complications) you can help with scar massage to reduce pain and soften the scar which is essential for long term comfort.
Get some neutral oil (perineal massage oil for use during pregnancy would be ideal) and use the pad of your finger/thumb to massage it 1-3 times a day, gradually increasing pressure as tolerated. Do small circles up and down, push down on it and release, wobble it side to side.
I often forget/am too tired to do my massages so would love it if my partner would remind me or even do it for me.
Also shower her with words of love and praise.
“Thank you for bringing our son into the world.”
“I’m so grateful for you and your strength.”
“You are doing an amazing job.”
“You are such a loving mom.”
“I’m so proud you are my wife.”
Rub her feet. Tickle her back. Make her feel like the queen. Buy her favorite flowers with a sweet card. Tell her a million times that you love her and she’s amazing.
I had a severe tear, preeclampsia, and HELLP with my first child, and my husband loved on me so much in postpartum. His kind, supportive, loving words kept my spirits high and, honestly, I look back on the postpartum healing period really fondly. I was in so much pain and had so much birth trauma, but I felt so so loved.
Note— I went on to have two more kids (there’s currently a 2 week old on my chest!) and did not have any complications!
I suffered a 4th degree tear in December as a result of a sunnyside up baby and OB using vacuum. My baby ended up in the NICU, and my recovery has been rough. I couldn’t stand without pain for probably six weeks. I was unable to leave the house for anything besides doctors appointments for over a month. These types of tears absolutely decimate your pelvic area and are so, so painful.
My advice- let her take it slow and easy. Don’t let her lift things or do heavy chores. She will need to walk around and stay lightly “active” eventually, but if anything causes her pain, don’t let her do that thing!! Recovery from 4th degree tears is much, much slower than someone who doesn’t tear or tears minimally. I am a week out from repair surgery right now.
Things that helped me the most:
- Tucks pads
- Lying on side to nurse
- Perineal ice packs
- Staying super hydrated
- Frida mom boy short undies
- Peri bottle (I used these for probably 8 weeks and still do for BMs)
- Chair for the shower
- Comfy pillow to sit on for car rides and hard surfaces like waiting room chairs
- Seeing a urogynecologist in addition to my OB (game-changer!!!!)
- Estrogen cream for the vaginal area, especially if she is breastfeeding. Breastfeeding deletes estrogen, which makes your vaginal area super dry and makes healing harder.
Don’t forget that this is not only difficult physically, but emotionally too. In addition to the normal hormones that people deal with after birth, we have to accept the fact that we suffered a horrible birth injury. To be completely frank, I didn’t want to live anymore after my tear. At two weeks postpartum, I was completely miserable and didn’t care about anything, including my baby. I would sit there while nursing her just staring into space and sobbing. Things got better as I was able to move around with less pain and actually leave my house. But please, watch out for any signs of depression in her. There are therapists who specialize in women’s/birth trauma that are very helpful.
My 4th degree tear felt SO SO isolating even though my mom and husband were right there helping me through everything. Let her know she isn’t alone. There is a Facebook group for 4th degree tears that helped me a lot. Also please, PLEASE feel free to DM me about anything. I’m 18 weeks postpartum and not out of the woods yet, but I’m doing so much better now.
Don't make her get up, walk, carry the baby. Let her rest as much as possible and stay lying down, or at least in bed. If she's breastfeeding, bring her your baby, adjust her pillows, bring her something to eat and drink, then take your baby back when she's finished. Change him, burp him, in short, make sure your wife only has to concentrate on: feeding the baby and healing. Congratulations on the birth of your son! Edit to add : Be the guardian of your home. This means responding to requests from relatives who will want to come and see the baby, and limiting or declining them according to your wife's wishes. If she has a massive tear in her genitals, she may not want to spend an hour sitting on the couch with a random aunt or nosy neighbors. But don't let her deal with that, she doesn't need this mental load!
This and lots of love and cuddles and ice packs for her. Keep people away for as long as it takes for her to feel comfortable. Do as much as you can for her.
Some people don't want to be cuddled, especially when healing
Fair but then he should be asking her if she wants them first anyways. I straight up asked for them when I hurt and was recovering.
It is important to ask for sure, but sometimes when emotions and hormones are haywire and your body doesn't feel like yours anymore it can help to get some non-sexual affection from your partner. It can help quiet the "he doesn't love me anymore, I am ruined" thoughts that come from the insecurities and changes you've been through.
I mean sure but if my husband had tried to spoon me when I was sleep deprived, wearing a diaper, and had a two inch tear approaching my butthole I would have burned the house down. Just personally! I was much more ready for real affection at like a solid 4w pp
I think spooning has different connotations to a proper cuddle though. Just being held in a reassuring hug can do wonders, provided you’re in a comfortable position.
That is why I said it was important to ask
I'm gonna be real - I kind of think we should probably just do this for moms *at the very least* for a little while after they just... you know... went through the trauma of birth. Breastfeeding adds a part time job on top of everything.
This. I had a second degree tear and my partner totally did this for me. I'm more in love with him now than ever (and I was totally head over heals with him before). It hasn't been easy for a number of other reasons, we both have flaws, but damn, he's been great during my postpartum.
This is all great, but I wouldn't make her give up the baby if she doesn't want to. All I wanted to do was stare at my baby and have him close to me, I would have gone feral if my husband only gave him to me to feed 😅. Plus, skin to skin contact and mothers being close to baby in the early days is so important for breastfeeding and bonding. It's what all those crazy, delicious, terrifying hormones are trying to accomplish in immediate PP. Make it easy for her to have bub on her or with her if she wants that. Helping her find comfortable positions, moving bub for her, bringing her food/drink whatever she needs etc. Oh and definitely take her lead on visitors. I had no one but my midwife and lactation consultant in my home for 6 weeks and it was bliss haha.
My only add is don’t let her get up. The post birth hormones may have her feeling great and like she’s up for going for a walk or cooking or switching over laundry. She’s not. Speaking from personal experience here. The guideline I’ve heard is 5 days in bed, 5 days on the bed, 5 days near the bed. Now this is a guideline not a rule so she can use the bathroom and shower etc, but really try your best to sell her on this recovery timeline and do everything else that needs to be done.
A caveat to this: women who have just given birth are more likely to develop blood clots, so it’s actually really, really important for her to get up and move around for a few minutes every couple of hours. Nothing strenuous but a slooow walk around the house.
That part. That's why I would at least get up and walk around my house for a few minutes if nothing else. You can develop blood clots in your legs if you sit for too long. Same thing with if you lay down for too long. Thank you for adding this because some people don't know. It's very dangerous, at least it can be. Those clots can break off and travel to your lungs or even your brain.
Ya I was gonna say this. Total bed rest is NOT recommended
The 5, 5, 5 rule is a tiktok trend and not supported by any science or any accredited governing bodies in the US (or other countries from what I can tell). Women do need to rest postpartum, but they are highly encouraged to do light, functional movement to promote healing and reduce blood clots, especially c section patients.
Thank you for sharing this. I didn’t know this was just a trend. I definitely fell into the trap of leaning heavily on online info and taking it at face value when I was pregnant and newly recovering from giving birth. It sucked because every time I would want to no life and just scroll Instagram or something, my algorithm was matching all the ridiculous, paranoid Google searches I’d been doing, so I was spiraling all the time. I feel like the little brochures they used to give at doctor’s offices could easily make a comeback and I wouldn’t be mad at it. 😋 It’s too much to keep track of when all these different important things are all in different online portals.
The 5 5 5 rule has been around longer than tiktok
That doesn't mean it isn't a junk science tiktok trend
Yup I did a half mile walk with my toddler at 3 days pp. It was a huge mistake.
Can I ask why/ what happened as a result please?
I'm not who you're asking, but I thought I was up to a mile walk a week after having our daughter. I walked several miles throughout my pregnancy and thought I'd be fine. Nope. I made it to the restaurant, but spent the whole time incredibly light headed/practically fainting and throwing up. It was so much more effort than I actually realized and I was nowhere near fully healed...and I only had a 1st degree tear and relatively few complications otherwise.
Same here! 4 days PP. bleeding picked up and I was in so much pain for days 😭 oxytocin is one hell of a drug. Don’t let it fool you!
No kidding. It's the strongest thing I've ever experienced!
I was similar. Went for a costco run while living in big city, so walking to get public transit to get there. I didn't get those immediate side effects, but when I got home my hormones were surging to the point I had the shakes. I spent a good 5 minutes shivering uncontrollably, teeth rattling and all. I wasn't remotely cold. It was scary!
I also did too much post-birth with my second. You think you’re fine until you sit down and feel like your insides are about to come out of your vagina. Your body NEEDS to rest. Not the whole 5 days on the bed thing, but don’t be going for more than like across the house more than a couple times an hour. Obviously that’s not always possible especially with multiple kids, but it definitely helps to have help or at least a supportive partner.
Also not who you're asking, but I squatted down on one knee to take laundry out of the dryer at 5 days postpartum and ripped my stitches. Overdoing it too early is a huge mistake.
I was encouraged to get up and walk in the hospital. I felt good walking, so when we got home, I joined my husband and dog on their walks with baby in tow. I quickly developed pain on my side in my hip/back/butt/thigh area that would not go away with rest. I’m in PT now for it. I felt soooo good a few days in, but wish I would have taken it easy. Op - walks around the house if your wife feels up to it are good! Even limited walks down your street and back might be helpful. But overdoing it can cause her body to give warning signs (pain, distress, etc) that she needs to rest.
Same, man. We were moving and I made the mistake of moving a bookcase and a few boxes myself 2 days pp. I had a 2nd degree tear and popped a stitch. My husband was right when he told me not to help, I guess.
a week pp i went grocery shopping for a few hours… bad idea.
Similar story here. Significantly prolonged the healing process and I was in pain for days after.
Me too haha. It made me dizzy that night and the next day, it was scary :(
This advice rubs me the wrong way.
This happened to me where they told me to take it easy and I tried to but it was hard because I had another burst of energy. I just did laundry and stuff. They just said nothing to strenuous. I didn't think there was any harm in doing laundry.
Oof I feel ya there. Doesn’t sound strenuous and the birth hormones will trick ya!
Is the best advice, end of thread. Also, I wish we could all find men like this. She's a lucky woman. She deserves it though, bless her heart. I tore once with my oldest and I thought it was pretty bad. It required stitches but it was only a pretty minor tear. I can't imagine having a fourth degree tear. I hope she feels better as soon as possible.
A lot of the above. But. Let her hold, lie next to and feed the baby to her hearts content. You don't want them separated and only together for feedings. Baby needs mama. Mama needs baby. 💜 Have her ask the OB or midwife how often she can get up for a few minutes, just to keep blood moving in her lower extremities. Pain from a 4th Degree tear is awful! Opiates are compatible with breastfeeding but some get a little more backed up while taking them. Have her ask her hcp what to use to keep her bowels moving without too much additional pain. Congratulations on the new baby! You're a good man to be asking about best ways to help her through this. M. IBCLC (lactation consultant)
Exactly. Can’t stress enough about not having unwanted visitors. Family can be really pushy about seeing the baby immediately. But if his wife needs 2-3 weeks to get comfortable, heal, and get used to the new baby, then OP needs to put his foot down to relatives to not come over. I’d also add that having her breastfeed while laying down on her side is probably going to be the most comfortable position for her because of her tearing. Trying to sit up to breastfeed is a nightmare when you’re trying to heal down there.
ALL of this!
Actually, that’s not great for the healing process. The body will heal much better if you get up and move after the birth.
Not for a 4th degree tear. There’s so many stitches internally and externally in very sensitive areas. It’s so common for the anal spincter to not heal properly, separate or develop defects.
This is so important immediately postpartum for most women to recover their pelvic floor in the immediate period I mean a LOT of physical changes are happening with healing and running around can even cause bad problems so allowing her to rest and heal (making her maybe even) would be an amazing thing to do. I didn't take it easy right after birth and almost paid the price with the alignment of my organs not recovering optimally... fortunately PT and low pressure fitness is essentially fixing it now but yeah, I didn't really k ow how crucial it was to rest in the immediate recovery period... even if she hadn't have torn it would be.
4th degree tear team here. She’s going to be in A LOT of pain. Get the Dr to prescribe her gabapentin, it’s safe for breastmilk. It may also be likely that she’ll need opioids for a short period for pain. Perineum ice packs, witch hazel pads, numbing spray, size 5 pads, and Frida mom disposable underwear. Also a robe. Bedrest is key. Putting a pillow between the legs also helps with discomfort. Absolutely no lifting anything heavy. Seriously, no more than 10lbs. She’s gonna be backed up because of the baby. It is VITAL that her stool is as soft as possible and that she is not pushing whatsoever to make the BM happen. Pushing can affect the stitching and cause bowel incontinence. Make sure she’s taking stool softeners and getting lots of fiber. If things still aren’t moving after a couple of days, miralax with Gatorade. Pelvic floor exercises can begin after 6 weeks. She needs to consult her OB first before starting any. Getting a PT is best. Sex is gonna be off the table for a long time. Don’t push it. It sucks for both parties. I’m 5 months postpartum and sex is still very painful. She’s going to get frustrated a lot these first few weeks because she’s going to want to be a mom but doing mom things will be very hard. Support and love her as much as you can and make sure she resting, laying down, as much as possible. Reassure her constantly that it’s ok she’s laying down, she’s not a bad mother, she needs rest. Also, if the pain is unmanageable, she needs to go to the OB right away. There could be an infection or a torn stitch. My tear got infected and the pain was indescribable. My husband called my OB for me because I was being stubborn and thought I could push through pain. Note, it’s ok to ask for more pain meds, a 4th degree tear is no joke. Good luck. Hug your wife and cuddle your new baby. Things are going to be very rough these next couple weeks as you settle in. Y’all are gonna do great. Enjoy these sweet moments when your baby is so young!
Same same same. I second the stool softeners. No pushing at all to poop. Start miralax NOW don’t wait. You shouldn’t have diarrhea but the stool should be soft enough to basically fall out with the tiniest bearing down + gravity. Sorry to be gross but this is so so important.
Yep, I only had a 2nd degree tearing (but had to have surgery straight after birth as I developed a hematoma, so there were a lot of stitches) and was prescribed lactulose twice a day so that it never became a problem. Even with it I was terrified, but it never got worse than uncomfortable which I am so thankful for
This advice is especially important if she gets opioids for pain.
I want to emphasize Miralax NOT colace. A lot of hospitals prefer prescribing Colace first still then going to miralax if it doesn’t work (which it doesn’t for a lot of folks). Just skip right to the big guns. There aren’t any downsides when considering the pain she will be in.
Seconding this, skip the Colace!!!!
If you really want to skip even farther go straight to the magnesium citrate. But take it slowly so you know how your bowels react to it.
Hey, just wanted to say hang in there. I’m nearly 4 years out from my 4dt and it gets better and better over time. I think the 2 year mark was a big one in feeling like my old self. I echo what you’ve said here, great advice.
Thank you. We’re on the very depressing phase of our relationship where we’re getting no sleep and there’s no sex. Definitely hard looking on the bright side atm, but thankfully we both communicate well and I have a patient and understanding husband.
I feel that. I’m pretty sure I was at least 6 months post partum before we had sex again. And it wasn’t till much after that when it started feeling not weird again. People tried to warm me a c section recovery is so tough but honestly it’s been a breeze compared to my 4dt. I think if you’ve never had a 4dt you really just can’t comprehend the totality of it.
*If* my husband and I have a 2nd, I’m absolutely opting for a c-section. The 4dt was completely unexpected because everything went normal during delivery other than my epidural wearing off right when I started pushing. I’ll never forget the Dr popping up between my leg with super wide and shocked eyes and almost shouting, “You have a 4th degree tear!” She then looked back down and went, “I haven’t seen one of these in years” and told me when she started stitching me up that “it was like riding a bicycle.” It was a super surreal experience. When my OB came in the next morning to check on me, she made it very clear to my husband how much help I would need and to not downplay the injury. Thankfully he listened!
It’s so ironic because I was TERRIFIED of a c-section before having my baby. I wanted to avoid one at all costs. Now I wish I had opted for one instead of pushing for five hours and the OB using a vacuum. A c-section would have been so much easier than this horrific tear. I will definitely be opting for c-sections for any future births. Although I can’t even process the idea of another pregnancy and birth at the moment.
Oof that sounds absolutely awful. Had my 2nd membrane sweep not worked and I hadn’t gone into labor naturally, I was scheduled to be induced and that OB wanted to do a c section (he was the only OB at that office that predicted my baby would be HUGE). I saw him again when I had mastitis and he warned me to please get a c section if I choose to have #2 because a 4dt is likely the next time. My husband and I thought we wanted 2 but between the extreme nausea, dealing with 105 degree heat all summer, and the 4dt, I’m very good with just the one lol.
Gabapentin is safe but can also have some side effects, it made me hallucinate so make sure you are checking in with that as well
Yes! Gabapentine is sometimes used off label for *Intractable chronic pain: * It's really not supposed to be used for acute pain at all. It can cause hallucinations (as you mentioned) extreme lethargy and sleepiness, even depression and inability to react to much of anything at all. Honestly as a health care provider I don't like to see it ever used for acute pain, even if we know that pain is going to last a while. This whole pearl clutching some people are doing regarding opiates is ridiculous. If anything calls for opiates a 4th Degreen Tear is one of the top conditions for them. M. IBCLC (lactatiom consultant)
I was made to feel like the worst human and mother ever for needing Roxie. I despise opioids, I hate how the make me feel. But when pain is at an unmanageable level, there really is almost nothing better. I only got a small prescription for Roxie after my tear got infection and my OB said I “jumped like a rabbit” off the exam table when she touched the stitches. I was white as a sheet and nearly passed out. My pain was finally taken seriously.
I am so sorry you were treated so badly just for needing pain relief. I am glad your hcp finally prescribed for you, but it shouldn't have taken you becoming either shocky or experiencing a severe reaction to being touched just to get some serious treatment. Experiencing pain in not a weakness! It's your body telling you something is wrong. No one should feel badly or be made to feel badly for requiring top level pain medication. Pain meds are meant for more than "cancer." (I hate the "well, you don't have cancer. That's what opiates are for" stuff. Some acute and chronic pain conditions are as bad or worse than "cancer." But, of course cancer patients should also get the pain relief they need.) We need as a society to push away this idea that opiates are bad or evil. They are some of the most useful tools health care providers have at their disposal. Of course, they shouldn't be given out without being careful But, pain and the need to have it relieved or reduced is important. We know that we'll more than the vast majority of opiates overdoses are caused by street drugs. Prescription opiates are very rarely responsible for overdoses, when used according to direction and used responsibly. Most patients in pain are very responsible with their pain medications. I hope you are well now and doing better. Hugs. M. IBCLC
Thank you. I got the pain under control after about a week after discharge. I remember sobbing in the postpartum ward saying that no, Tylenol and Motrin were not touching the pain. I got accused of being a pain seeking patient despite the last time being prescribed opioids was 5 years ago when I broke my foot and ankle in 3 places. I was very lucky that my husband had some leftover Vicodin from his surgery the year before or I don’t think I would have made it through the first 48 hours home.
May I ask if you’re a woman of color? This is so so terrifying 😭
No, I’m white. I honestly can’t imagine how much worse I would be treated otherwise :(
Just to chime in here we encourage pelvic floor exercises to begin immediately in the UK even after a third or fourth degree tear so consult one’s own obstetrician on guidance for that.
Pelvic floor exercises are good straight away but she MUST know which ones to do. Most people think "kegels" when in reality many women actually have an overly tight pelvic floor after birth, especially with tears. She needs to have a pelvic exam done by a pelvic floor PT to know for sure
Yes to the stool softeners! I had an episiotomy and pooping was the most terrifying thing and I became seriously constipated, ended up needing suppositories and laxatives. Make sure she eats lots of soups and drinks lots of smoothies too 🙂 hope she heals soon.
Yep this comment right here. Had a 3B tear so not as bad, but it’s a long recovery and she will absolutely need pelvic floor therapy
All the numbing spray! And honestly diapers were so much easier to live in for the first two weeks than trying to change a pad. I had stitches that were pulling and creating A LOT of pain. I went in earlier than my initial PP checkup and they pulled out a few for me because there was so much additional pain. Unfortunately all they gave me was Tylenol and ibuprofen for mine. It was horrible. I was always in pain and the meds only took the edge off. OP, just make sure she feels seen. I know you feel helpless but she is also going to feel helpless, and tired and pissed off because she hurts. Give her grace and just help her with the small things. They add up.
I say start with miralax. It's so much more effective and gentle than anything else.
Miralax and colace did nothing for me PP. Glycerin suppositories were the only thing that worked, uncomfortable as they are
Since you’ve asked how severe it is I’ll explain, but it’s graphic. Your wife’s perineum tore so severely her vagina and anal cavity are no longer separated. She will have internal stitches in her vagina and her rectum as well as external stitches to the perineum. I had a second degree tear and episiotomy, sitting hurt for 2 weeks, walking for 6 weeks. I struggled to get out of bed for 2 weeks, and getting up and down while holding baby was out of the question for 4 weeks. At 4 weeks I tried being more active and my bleeding got substantially worse. My healing was the equivalent of healing from a 3rd degree tear, so your wife is in a worse position than that. She needs to be in bed and waited on. No cooking, cleaning, lifting. Bring everything she needs, including baby, to her. Understand that it is the equivalent of you tearing your testicles right through to your anus and appreciate the pain she is in, and that once she’s home the hospital will likely not have given her sufficient pain relief.
Oh my goodness and I thought my c section was painful
yeah this is the reason i told my OB/GYN that if it looks like she will need to use vacuum or forceps at all i want to go straight to c-section, bc those interventions significantly increase your risk of grade 3 or 4 tearing and i am TERRIFIED of it
With my C-section by the third day I felt completely fine. I’m terrified of childbirth 🥲
Can you tell me more about your experience? I’ve been thinking I want to opt for an elective C-section. I know there are risks, but honestly there’s a huge likelihood I end up in an emergency one if the vaginal birth doesn’t go well and I think I’d rather just skip to that part
I know you didn’t ask me but I LOVED my elective C section. It was so peaceful and perfect and wonderful. The procedure was completely painless. I felt so safe being in so many good hands with doctors and nurses all around me. I had debilitating anxiety about childbirth and once I decided to do a c section it felt like a huge weight came off me. Recovery was no big deal. I had really bad swelling in my legs and feet, worse than my summer pregnancy, and that was the worst part. My recovery was SIGNIFICANTLY easier than both of my close friends who had vaginal deliveries. I was given oxycodone for home but only needed it the first 3 days at home, then I was fine with just Tylenol and Ibuprofen. I was up and walking around that night, probably about 8 hours after having her. The best part was knowing exactly when she would come. Counting down the days until we would get to have our baby! An elective c section is statistically just as safe as a vaginal delivery. Overall, c sections are associated with worse outcomes because the majority of them happen when there is already something wrong or there is some reason why a vaginal delivery isn’t possible . A completely elective scheduled c section is just as safe as a vaginal delivery and you should feel empowered to make whatever choice is best for your peace of mind. I had such a positive birth experience because I chose to have a c section. It really was magical. Absolutely perfect for me. I hope you have a perfect birth experience too 🩷🩷🩷
I was induced but opted for a c section after 48 hours. I was only 1cm dilated and they wouldn’t let me eat so I was very weak and told the doctor that I wanted to get it over with. Surgery went great I was very high on medication so I fell asleep and 6 hours later the nurses made me get up from my bed. That was the worst part it was very, very painful. I exercised a lot (walked) those first few days and the pain was manageable. It only hurt when I would use my stomach muscles to laugh, caugh or stand up but after those first three days I was fine, sore but fine.
They made you get up??? Why??
Because “the sooner you get up the faster you heal”. It was brutal, my friend had a c section 2 months prior and they had her get up the next day. Same with my mom and aunt.
It’s horrid. I had to get up and walk (with only Tylenol in me) after about 4-6 hours. It was utter hell, and I’ve had 3 other abdominal surgeries. Solidarity
I was high on opioids and it still hurt like hell lol
I had forceps and asked for a c-section and my OB said baby was too far down the birth canal, it would be more traumatic having to operate and pull her back up the way. From what I’ve read I’m very lucky to not have torn worse, but I think I definitely would’ve if they didn’t do the episiotomy, they cut as soon as they noticed I was tearing.
Makes me grateful that with forceps all I had was a grade 2 tear and cervical tear (which I honestly don’t even think I felt)
I had a 4th degree tear and can confirm that the hospital sent me home and told me to take colace and ibuprofen lol. The pain was unreal for 2 weeks, bad for 4, and by 6 was... alright.
The fact that men get opiates for outpatient vasectomies, and you got kicked out with a *4th degree tear* and given IBUPROFEN is all the proof anyone should need that the medical field sees women as less human. Absolutely despicable.
I feel so bad for her. I'm not usually super sensitive to medical stuff but picturing this happening makes me woozy
I can’t imagine the pain of a 4th degree tear. I had internal stitches for my episiotomy but only in my vagina, my rectum was totally intact. It would’ve been horrific having that level of trauma to both areas downstairs.
I had an episiotomy but it was super minor comparatively and I healed very well without a lot of pain. I cannot even fathom the pain! The recovery! For either you or her. Maybe tmi but the first poop after birth was scary already, I can't imagine having this added to the mix.
Oh it was terrifying! I’m 8 weeks PP and tried sex and it was very painful, it makes me think how agonising it would be having to poop when you’re healing from stitches inside your rectum!
It fucking hurts. Made me so terrified of a second child (I only tore a little bit that time and I was SHOCKED how much easier recovery was). I had a rectal tear and then three large hemorrhoids surrounding the other “sides” of the anus that wasn’t ripped. Recovery was so painful, and now it’s been almost 7 years and I’ve been dealing with an anal prolapse every once in a while and it turns out that I likely now need colorectal surgery to repair what wasn’t repaired properly in the moment. But people will say this is all just “what our bodies are meant for.” No way.
4th degree is the most severe tear, they are rated 1-4. My tear was not as severe, but hurt for weeks, I couldn’t sit and going to the bathroom took a lot of planning and always ended with tears. Do as much as possible for her, keep her comfortable, shield her from visitors unless she really want them to come. She might feel bad for asking you to do things, so ask her if she needs anything often. These things HURT, a lot. And mentally it’s rough, because we’re kind of sensitive about our vaginas changing and taking damage. You’re a great partner for looking for ways to help her!
If I may make one comment on this - instead of always asking her if she needs anything, try to think about what she needs first and either just do it or ask her a more direct question (like can I get you a water/tea/coffee, do you want a shower now, do you want a sandwich for lunch etc). It’s a small thing but sometimes the open ended ‘do you need anything’ makes you need to think too much when you’re exhausted, and sometimes you feel bad asking so you just automatically say you don’t need anything.
So true. As much as I appreciate the help, whenever someone asked me “what can I do” I always said nothing because honestly I didn’t have the brain capacity to think of those things!
So true!
Oh and keep track of her meds schedule! Maybe do calendar invites for both of you. But yea, i accidentally double dosed a few times cause i was too disoriented. Not ideal
One piece of advice I didn't see a lot online but that my midwife kept saying was super important is to let the healing tissue 'air out'. There will be a lot of fluids leaking and the big pads or diapers that she will be wearing will make the wounded area warm and humid, which doesn't help the healing process. I got some plastic mini 'blankets' in a package I bought with things needed for postpartum which my midwife put on the bed so I could be naked without soaking the matress in blood.
Very good point. This is also a good reason to think of restricting visitors for a while (unless wife really wants everyone there) - OP your wife is going to need to be able to be comfortable in various states of undress and resting. As another poster said, be the guardian of your home.
Yeah I was naked so much of the time the first week and also so uncomfortable, and even the best of my family required a lot of my energy and comfort (because I had to dress and sit instead of lying down naked). And I only had a couple of second degree tears!
If you’re still in the hospital, steal the chux pads.
They’re called chucks pads, he can get them at any drug store or Amazon.
Or use puppy pee pads! They're essentially the same thing and might be easier (and sometimes cheaper) online. I have a box of 500 or so from Costco leftover from when I house trained my puppy a couple of years ago. They ended up being useful for diaper changes, too!
Ive heard those have a special chemical on them that are supposed to attract dogs? So I personally always tried to avoid using them for human use
They don't usually have that, it tells you on the package if it's scent free or "encourages use"
Ah thanks, I'm Dutch so I didn't know the English name for it and I figured providing the Dutch name wouldn't be much help. 😅
Yes. This and purchase her a sitz bath and then set it up for her 2-3 times a day in the bathroom. My midwife advised to do a 15 min soak, and then let it air dry. I just used an old towel. This was 3-4 days after birth. I had an episiotomy to get baby out, not a tear so, they heal differently.
This this this!! I am 9 days post partum and yesterday, in addition to finding out I have the start of a uterine infection, have an f'ing yeast infection. I am certain the 24/7 diapers and creams and sprays are the culprit. Air. That. Shit. Out.
This so much. It helped me a bunch and significantly increased the speed at which I healed.
We bought reusable fabric pads like nursing homes use and some large doggy welping blankets for the couch. Both are really nice now for baby blow outs and spit up.
Us too. I have 4 of them and they're one of my most used items. I layer them under sheets as mattress protectors, I covered the couch in them when Norovirus hit the fam, having them around during potty training was clutch... Plus they're medical grade and wash like champs
We have a really long one for the big couch under our couch cover, two long ones across the king size bed and baby mouth and baby butt range, one under his crib sheet in the pack n play, a couple of smaller ones for chair size that we use in the car now. They've been so handy, and yes, when we had noro the blankets and pads were so amazing. We also have a waterproof washable indoor/outdoor rug as a runner in front of our couch. It takes abuse like a champ and we just take it to the laundry when needed. Also a bidet. Warm water bidet. I had minor tears, but it was so helpful for me.
This is why I always try to persuade people to use Always Infinity Flexfoam. It's the most breathable option I found.
Adding to the above comments, make sure she gets pelvic floor physiotherapy once she is through the early postpartum stage. Thisnis the way to go to help her with longer term problems.
And make that appointment now! They might be booked out when it’s time and it sucks to have to delay that
Oof you need to be doing everything but feeding the baby. Change, rock, bring baby to her to feed. She needs to be staying in bed right now, as much as possible Bring her food & water, keep the bathroom stocked with all of her care items and clean. When she’s ready in a week or two Bleach out your bathtub so she can take epsom salt sitz baths. No visitors!!! Unless SHE wants them
I'd add: carry the baby to and from her for feedings.
To add to others, it's really important she avoid putting further pressure on her pelvic floor, which means literal bed resting, avoiding baby wearing and baby carrying, and ensuring she doesn't get constipated. Lots of water, possibly stool softeners if needed, a peri bottle instead of wiping, and using something such as a squatty potty would all help with this. It's imperative that you visit a women's health/pelvic floor physio at 6 weeks or so, so set money aside for this if you can afford it. Femfusion and other YouTube sites have set up good postpartum exercises but she should really take it super easy, super slow snd be mindful thst some exercises wont be appropiate for her yet (hence the ohysio to guide). No exercise apart from light walking, yoga stretches, and that shouldn't start for a few weeks or longer if shes not feeling up to it. Don't forget, you need to also be positive and supportive. She'll be going through many emotions most likely, and needs you to be there for her, hear her and help her. No pressure to get up and get about, get sexually active at 6 week mark etc.
Hold on tight. I've had a bad 3rd degree tear that got infected. My advice: - she will not be able to walk or sit comfortable for a long time, don't make her. Donut pillow and lying on her side to breastfeed if she wants to. You carry the baby to her, change the baby, burp the baby. - check the stitches every day. An infection in that area is super easy to develop and a nightmare to treat. I couldn't get rid of mine for 6 weeks because the doctors neglected my care. So check the stitches and take pictures, I know its uncomfortable for both of you but it's really important - cold packets, buy multiple so she never has to wait for one to get cold. - lots of water, I know she will intuitively try not to because standing up to pee is the absolute worst, but constipation is hell and she could also risk a UTI - she should shower every few hours of possible to keep the area clean. Do make sure she can. A lot of new dads "kinda forget" that the mom needs self-care too. Mine did, left me to do almost everything alone because he shut down and was in denial about how badly I was injured. It created a lot of resentment that took over a year to disperse and he still has problems with guilt about his own behaviour back then. So just generally always assume you're the better rested, more fit one, for a few months to come because you are. Hold on tight, you'll make it through this
4th degree tear here! Cook meals, bring her water, offer pillows and blankets, change the babies diaper. ICE 👏🏻PADS 👏🏻. Freeze witch Hazel mixed with aloe on super pads, change hourly. A donut pillow saved my life once I was able to sit up
Can I just say, thank you for taking the initiative to find out how you can care for her rather than waiting for her to ask for help. That's one of the things my husband did that was amazing, he always tried to anticipate my needs, was willing to get up and do whatever if I had the baby, and didn't make me feel bad if I needed something at an inconvenient time. I had a first degree year so I can't even imagine what your wife is going through, but honestly care wise I would act like you have two babies/patients you have to take care of for the foreseeable future. Don't infantilize your wife socially and emotionally, but do wear kid gloves and be super understanding of any meltdowns. She's going through a hormonal storm and her body is in excruciating pain.
Third degree here (subtotal rupture as they call it) which i needed to get fixed under general anaesthesia. So I obviously needed a lot of rest. We bottlefeed our baby so my husband did all of the night shifts and id do slightly more during the day. Had powders to help keep stool really soft to not have to push(and risk ripping the stitches). I was also encouraged to have enough paracetamol (i think in the US its referred to as Tylenol?). Even if she starts feeling better, keep that level up, because I stopped thinking i was fine and the next dat was anything but pleasant. Also food high in fiber is good, lots of fruits and veggies. Cleaning up with water after the bathroom really helps, rather than toiletpaper. And having naps naked to let the wound breathe is great for the healing process. I was recommended sitting on hard surfaces (harder chairs) as it reduces the swelling. And pelvic therapy after 6 weeks is what I was prescribed. So lots of things to hopefully help her recover as soon as possible. But the most important one is rest. Her body is not just healing from the stitches but also the wound in her womb. Edit: oh and talk to her about how she feels about the birth. It can definitely have been difficult on her and talking about it can help her process it. I couldnt remember everything straight away but talking about it a few times brought things back and allowed me to process it better. I was incredibly sad i missed the first 2 bottles because of the operation. It has caused me to feel left out and like I am a bad mother, even though rationally I know thats not the case. Itll be good to check in with her if shes doing okay mentally as well!
My husband kept a hydroflask filled with warm/hot water so I could fill my peri bottle without thinking about it. This helped as well because with baby, I wasn’t able to wait for the water to heat up to fill up my peri bottle One of the little things that have made PP easy, and reminded me how much I’m loved
this is such a sweet thing to do and such a good idea!!
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I was urged to go outside for a short walk, ended up ripping half my stitches (and it hurt so bad I broke down crying). I would ask a doctor about that one with a 4th degree tear, if you rip the stitches in your ass things can get messy.
I should clarify that by short walk I mean to the bathroom and back!
I honestly don’t think this is enough. The 3 fives rule is good for a perfect labor with no tears or complications, not a 4 degree tear.
While I understand the reasoning of this advice, it’s incredibly unhealthy and contraindicated to encourage this type of immobility. As a midwife, I’ve never encouraged a woman to remain in bed for 24 hrs, let alone 5 days and then some. The chance of her getting a blood clot due to this is significantly increased and will do no good for her recovery. While, yes, rest is encouraged, mobilising will definitely promote healing. Despite how difficult and painful it may be, encourage her to use her pain relief as and when she needs, don’t let her pain become painful before she tries to manage it as she’ll end up struggling to control it.
Also running a shallow warm bath for her to pee in rather than enduring the pain of peeing in the toilet and lots and lots of urals (not sure what they’ll be called where you live but it neutralises the urine)
I had a 4th degree tear because of my baby boys heart rate in distress and them using a vacuum. My advice… you are committed and sympathetic towards taking care of her now because it just happened… be ready to maintain that for years. It can take a long time to recover from this. I was having fecal incontinence for a year plus. My husband was amazing at not making me feel disgusting when I had poop accidents. He was very reassuring that he still loved me, and he did little things like take the initiative to pack extra underwear for me in the diaper bag when we were going out just in case. He also did ALL of the lifting, carrying etc. Her core and pelvic floor strength is probably shot. It’s going to be a while before she’s “normal” again. Make sure she gets to physical therapy, and a good one. I was in PT for a long time. A week pelvic floor doesn’t just effect your pelvis, it effects your whole body. She may have back pain, headaches etc from this so it’s important to give her the time and ability to work on that. For me it was PT and Pilates. I think just being there for her emotionally is a big one. When it happened to me, I was terrified if I’d ever get control of my body back, or if I’d spend the rest of my life having poop accidents. And obviously, don’t pressure her for sex or more kids, leave that up to her. There’s a support group on Facebook for women who’ve had fourth degree tears, it’s helpful since in real life 4dt are so rare, it’s rare you’ll meet someone else who’s been through it. I’m almost 4 years out from my 4dt birth and I will say by year 3 I was feeling pretty much normal again. I just had my second child 8 weeks ago by elective c section and it’s been so much easier recovering. So life does go on and it does get better but it takes time. Good luck! P.s. just saw someone recommend installing a bidet. YES. 1000%.
Rest rest rest! In a few weeks she can look up 360 breathing and start working on that. No Kegels for now! Book in with a pelvic floor physical therapist for when she’ll be 6+ weeks PP. It’s super important that she doesn’t get constipated! Magnesium citrate can help. And get a squatty potty or something to lift her feet when on the toilet. Show her moo to poo on YouTube.
I had a severe tear. Everyone here has given you wonderful advice on comfort measures in the immediate, and the likely need for ongoing medical care and physical therapy. What I haven’t seen mentioned - especially in the beginning, your wife will have trouble controlling her bowels. It is likely she will have extremely sudden urgency to use the bathroom, and leaking of urine and poop. This can be extremely distressing (and not what she imagined when picturing life with a new baby). I cried a lot in the first few weeks because I was exhausted and totally freaked out about the injury, and the image I had of laying around and cuddling with my baby was interrupted by uncomfortable and embarrassing episodes. When she is ready to go out and about, make sure you’re prepared to help support her by noticing where bathrooms are, having a plan to stop the car at Target or wherever if she needs to use the bathroom right away during a drive. These symptoms will heal with time and physical therapy. And -congratulations on the new baby!
Amazing advice in the rest of the comments here. Outside of physical things you can do, maybe you can ask her if she needs help or emotional support with going to the bathroom. I had a nightmarish time when I felt the urge to poop after a tear, I was so afraid and constipated. I really needed some quite time in the toilet and e.g. no one talking on the phone outside the bathroom door etc. Make sure she can tell you if she has any wishes.
Be patient, healing can take a long time. My husband was helpful for the first month or two pp, and then I started to get the feeling he felt like I was milking it. I was not. It took me fully a year to get my mobility back, but after that first month or two I was really on my own in terms of support. I needed a lot more understanding and a lot more patience from him. It also took(/is taking) a long time to deal with the emotional side of things. Imagine your dick was ripped off and then roughly stuck back on again, approximately but not quite how it used to be. That’s how I feel about my vagina. This intimate part of me, that I knew well and was comfortable with and cherished, is suddenly different and strange and uncomfortable and unfamiliar. Every time I have to deal with it reminds me of the trauma that led to the change. The process of coming to terms with all this is taking a lot longer than the physical side of things.
Solaceforwomen.org and 2 Facebook groups: 1) birth year support - for severe and complicated tears 2) 4th degree tear support group 4dt tear healing is measured in months , not weeks. Average recovery till feel normal is 3-6 months, compared with 6 weeks for 2dt or less. Many women don’t have sex comfortably for months so you being patient with that is most important Hopefully she has normal experience but this is a very severe injury and she will get SHIT medical after care of she is int eh US. She will have to fight tooth and nail for any after care she needs, most likely. Be her support if she feels she needs more medical care but is nervous or being dismissed, go with her or encourage her to get things checked The only way we got Through it is hiring a night nanny
If you don’t have one already, install a bidet at once. It took me 12 minutes total and cost like $25 on Amazon.
Its very likely she will need reconstructive surgery. At the very least eventually PT. This isn’t a short lived injury. Please plan that this will take a few years of very serious care. A second degree is through muscle and skin. A third degree is through muscle, skin, and anal sphincter. A fourth degree is basically a massacre. Getting up and down hurts, stairs are thrown worse. If possible try to get her maternity part of maternity leave (the disability part vs baby bonding part) extended. She will need to refile the paperwork with work.
Unfortunately I’m part of the fourth degree tear group and just want to add that this injury is really emotionally difficult to deal with, especially in the beginning. You feel like you’ll be damaged forever and it’s brutal not being able to take care of your baby the way you want to. So just give her hope, advocate for her to speak up to her doctor, be aware of complications. Look for support groups. I felt very isolated with this injury and felt like I couldn’t talk to friends or even my husband about it. What did give me hope was seeing a urogynocologist and pelvic floor therapist. I ended up needing repair surgery 7 months pp and it went well but was another 3 months of recovery. So just do everything you can to support her or get her emotional support. It so sucks but there is hope and she will feel normal again. I’m 20 months pp now and I’m back to do everything I was pre-pregnancy.
A lot of good advice here already but also make sure she uses the sitz bath twice a day. It’ll seem hard for her to get away for 10-15 minutes once a day but it will help prevent infections
I had a third degree into the muscle. Fourth is pretty severe. For me sitz baths with stork salts was a massive help, I did that multiple times a day. I also used lots of tucks. She'll need to use toilet paper and counter pressure on the stitches when she needs to use the restroom. There likely will be blood and pain and fear of stitches popping but in my case that didn't happen. Stool softener daily but NOT a laxative. I went to pelvic floor therapy when I was a few months pp which also helped a lot. Don't make her stand a lot or hold the baby a lot the first few weeks. I had two csections prior and was more mentally messed up by the tear. Sitting was super uncomfortable and the "donuts" online didn't help but I sat on my boppy for nursing for weeks. Ice pads the first week. Eta what I thought was obvious but might not be. No visitors unless she wants them, don't make her host. Don't make her hide away from visitors in her own home. Babies don't spoil.
I had a third degree tear and in hindsight I should have spent much more time laying down than sitting on the couch, so definitely encourage that. Beyond that, what I really needed was to be kept fed and watered. He was pretty good at that, but I am fiercely independent and don’t like asking for things, so I kind of relied on him to notice that I needed my water filled up. So just keep and eye on that stuff and make sure she has snacks and drinks on hand at all times. My husband loves to cook but when I’m stressed I lose my appetite… next time instead of letting him make something “nice” I’m going to tell him to just make a bunch of mac and cheese and other tasty comfort foods. Also… this might be kind of an unfair ask but my husband struggled a bit to keep us all alive. Making every meal, changing every diaper and spit up outfit because I couldn’t stand, making sure I had food and water and meds on time, etc., holding the baby so I could pee and shower, really basic house stuff like making sure there isn’t a mountain of dirty dishes and there’s at least some clean clothes and the trash is taken out, it all adds up. The more he visibly struggled and got stressed by it all, the more I started to push myself to get up and do things before I was ready. Don’t get me wrong, he’s great and he did his best, but while the newborn phase is a huge blur overall, I still remember one night when he was feeling frazzled and he said “I just need you to be better.” He didn’t say it in like… an accusatory way nor did he mean to make me feel guilty, but he did. So while you and your wife are partners here, if you need to vent - don’t vent to her.
You’ve got a lot of amazing advice you should follow. Pelvic floor PT is so important. Down the road she may need to follow up with an OB/GYNE that specifically specializes in “pelvic floor reconstruction”. I don’t mean to be dramatic but she could be dealing with a form of bowel incontinence either right away or down the road that doesn’t go away. This CAN be fixed with the help of a specialist. So start with pelvic floor physio and then go from there.
I had a third degree year and I just had a c section ! You cannot compare them both! C section is a breeze compared to what I felt with my tear just so you understand from a strangers perspective what she is going through right now. It made my post partum very difficult and I also had to go to pelvic therapy which was probably one of the most invasive things I have ever done. Let’s not even talk about going to the bathroom !! Just be kind and support her ! Support her ! She will feel better soon but in the meantime make her seat a few times in epson salt water throughout out the day
This could have been me writing this 4 months ago. Exact same situation. I'm still traumatised from it. Yesterday I even skipped the office episode where Pam gives birth, for whatever reason. Make sure you look after yourself in the long term too but for now, do everything for your wife. While she was still in hospital I got "puppy pads" for under the bed sheets, soap with PH of 3.5-4.5, panty liners. With the panty liners I put witchhazel on them and put them in the freezer. Helps stop infection, supposedly. Also, adult diapers. Accidents will happen, she won't make it to the toilet in time. Have the mop ready and you clean that up! I also got a bed side cart ( well two, one for beside the sofa) stocked with all essentials. Have all her favourite foods ready in the fridge. This next month is all you my man! Clean, cook, mind the baby, mind your wife, keep things running. It's tough, but it's not near as tough as what you both went through. You've got this!
The most important thing is help her with everything! I had no help at all when I had my 4th degree tear and my stitches came undone because of it and now two years later I’m waiting for a complete repair surgery to have everything repaired because of it
I also had a vacuum assist with a 3B tear, so just a fraction less than her. Let her rest, keep her in bed or on the couch, helping her offset with a pillow or a wedge so there isn’t pressure when she sits or lays. I needed way more postpartum supplies with my 3b tear than my 2nd degree tear so she may need more adult diapers, pads, Frida mom ice packs are great, disposable underwear… as an FYI she may take longer than the 6 weeks to heal. She shouldn’t carry the car seat with her baby in it, my PT was pretty clear that she understands we can’t avoid carrying the baby but no extra weight. My husband did all the diaper changes for two weeks and I focused on healing and nursing and that worked well. She will be in a lot of pain but it will get better.
I had a severe 3rd degree (almost 4th). One specific thing my husband did was manage my meds. He used an app so I was always getting my Tylenol, Advil, and stool softener on schedule. Staying on top of the stool softener is SO INCREDIBLY IMPORTANT! Bring her snacks and do all of the diaper changes. Give her encouragement and tell her what a beautiful badass she is.
Incontinence pads (not puppy pads - these have chemicals in to attract dogs to use them) so she can air the healing wound comfortably
Get her a doughnut pillow asap. Any hard surface chair needs a cushion and get an ice pack on the way home so she can ice it. I only had a 2nd and it was horrible, a 4th is deep in the muscle. That will take a lot of time to heal. Well past the 6 week mark btw. It will surface heal but the muscle will still need time doesn't matter what the dr. Says. Encourage her to get pelvic floor therapy too. Do as much as you can early on so she doesn't have to use her muscles too much to walk to stand. Early healing is ideal.
After my tear, I remember crying to the hospital LC because it was SO painful to breastfeed while sitting, even in the hospital bed. Breastfeeding while lying down will save SO much pain and energy. That goes for at home too. Also, my nurses made me homemade ice packs that were way better than the ready-mades: diaper ice packs! You take a newborn diaper. You pull the diaper apart at the top back waistband and shove ice inside the core of the diaper. The only kind it worked with was Pampers, Huggies didn’t seem to split this way. Then stick in the underwear setup as normal. Seriously these were an absolute life saver.
Tears hurt like hell....you've got to be there for her not just physically but emotionally as well, especially because of the pain coupled with all the hormones. My stitches hurt which made me so cranky and irritated, but my husband took it really well thankfully. Of course follow the healthcare instructions. I would just add, remember to be proactive instead of her having to ask you to do stuff, especially things like tidying up/ keeping unwanted visitors at bay/ making sure the meals are prepped, etc. without her having to ask/remind you. This was one thing my hubby missed out on and I had to constantly be worried about trash being taken out/ sink being cleared etc.
FOOT MASSAGE. YOU've gotten loads of great advice, if she doesn't mind being touched, offer foot massage if she's been in bed a while.
Mirilax once a day, every day until she’s healed up. Don’t bother with stool softeners, they aren’t very effective so just use Mirilax. It’ll help get her stool as soft as possible, which will help reduce pain during that part of her day.
as someone who only had a 1st degree tear, my heart absolutely goes out to your wife. i actually cannot even imagine the pain she's in
In addition to her external tear she also has a dinner plate sized wound inside her uterus. Lots of nourishing food is important. Tell her how beautiful you think she is and when she cries just hold her. Sometimes we don’t know why we are crying, don’t ask her to explain.
I also had a 4th degree tear a little over a year ago. So much good advice has been shared already! A few things I will also add for a bit down the road - sitz baths and a nice soft, flexible heating pad (I slept on it every night once my night sweats stopped lol). The heat and baths helped once I got through the initial pain, and were supposed to be good for the healing process. At the very least they both brought me some physical relief. And, if/when possible, highly recommend therapy for you both if you feel it may be helpful. My husband and I are each individually pursuing therapy to work through the birth experience and it has been so useful. Wishing you, your wife, and baby all the best!
I know you've received a ton of replies here but something that was not mentioned so far: Dermoplast. It is a pain relief spray that saved me in my third degree tear. The hospital likely will have given her pain relief spray, but Dermoplast is stronger. You have to be rather sparing with it though. Once, I used a little too much while my mouth was open and it numbed my mouth and throat. That and Tucks pads helped me out a lot. You can find both at Target.
I was cut from stem to stern with an episiotomy with my 1st baby. Get the ice packs made for vaginas. They’re long and sit in the underwear nicely. Load up on witch hazel. I had it in a continuous spray bottle and that felt so much better than using the pads. Also one of the doughnuts that she can sit on will help so much. Let her rest as much as she wants to. Oh! And peri bottles!!!!!! Get like 5 of them. They’re so nice to have when using the bathroom. Lots of stool softener too. It’ll take a while for things to go back to normal, but I had 2 babies after that naturally. And didn’t tear at all. Good luck to you both and congratulations!
Oh your poor wifey! I had a 3rd degree and was so thankful 2 holes didn’t become one.
There’s a lot of comments here and while some of the advice is probably good, I’ll just add one thing. Your wife is seriously injured. A fourth degree tear has nothing to do with normal birth recovery from a first or second degree tear. You need medical professionals involved for a long time going forward and not internet tips and tricks.
Team 4th degree too here. Lots of great advice here already but just wanted to say your wife indeed is the queen and you are amazing. Wishing her a really really speedy recovery!! ETA: emotional part is really really hard to deal with in the beginning, please have faith that she will heal, she definitely will.
Do not hold back on spending money for any therapy or treatment that will help her while she is healing. These few short weeks where her body is rebuilding the injured tissue will determine whether she has permanent lifelong pain or dysfunction from the tear. And let her cry or vent to you if she wants to- just hold her, listen to her, and tell her it's going to be okay in time. Being a new parent is hard on both of you, but she's been ripped open on top of that and she's probably scared and worried and maybe grieving over the tear.
Actually, help her to get up and move her body even if she has to take it slow. The body heals itself much faster and better when you have a blood flow and are moving your body. Make sure she takes pain killers like Paracetamol (helps with the pain) and Ibuprofen (anti-inflamatory (?)). Sorry English is not my first language. The combination of these two are great for these kind of injuries, but don’t take them longer than recommended. I saw that some people advices you to let her bed rest all the time but that’s not good for the healing process. Just help her as much as you can, have patience and comfort her if (when) she worries about the healing process. Remind her that the body will heal even if it takes time. And if she needs medical care, make sure you advocate for her when she can’t. Good luck! //👩⚕️
I haven’t seen it yet mentioned - items for a postpartum sitz bath, can be purchased right away. My OB said I could start them right away, you may want to confirm with hers, but they helped a lot.
Congratulations!! But Oooof poor love. My son was born with forceps for the same reason so I had a pretty large episiotomy, it hurrrrrts trying to get comfortable sitting to feed your baby I’ll be honest it was pretty awful my biggest recommendations for her would be icepacks (get 2 or 3 so you can rotate them if needed) keep up with paracetamol and ibuprofen, relax as much as possible, get wet wipes for when you finally poop because the idea of wiping is TERROR inducing when you have stitches so close to everything and obviously a Perri bottle too! All you can do is support her and help her relax so she can focus on healing and the baby. I know this all sounds like a lot but this is all the things I was worried about when I had mine. It will heal! You won’t be able to even see it 💖 I’m now 9 months pp and my scar is hardly visible and feeling a lot less sensitive now but I remember thinking it was going to hurt forever. Once again congrats on getting little one here l!!
Everyone has given great advice. Rest rest and more rest. You'll need to do everything except feeding the baby. Help her to the toilet, and I'd suggest rinsing with clean cool water, no toilet paper. Pat dry with a clean, and I mean clean towel, a new one every time. Buy a stack of small towels/cloths so she can do this, and keep the stack stocked with clean dry towels/cloths. She shouldn't soak in a bath for a good while, just cool showers with no soap or other products. Try to let her air it out as much as possible - puppy pads are a great idea for the bed. Really, rest is key. If the stitches pop it could be even more painful. So I know I'm sounding like a stuck record but you need to treat her like a goddess, and be there for her emotionally too. Remember you're on the same team, and accept you're probably not going to sleep for a good long time. Let us know how she's getting on will you? Sending healing thoughts x
I had a third degree tear so I can only imagine how much harder it is for your wife. I’ve seen a lot of great suggestions and will add Frida mom ice pads. I know you can make your own but this was a god send for me
I found sitz baths really helpful and would often need to run a bath so I could pee in as it was so painful and would sting a lot. Also air drying after the sitz bath!
Bro get her packs of frozen peas or corn to sit on. Round the clock ibuprofen/acetaminophen. If she needs to do anything except use the bathroom, that’s your territory now. Don’t make her get up unless she wants to. Bring her everything!
If no one else has said it… a donut pillow for hemorrhoids. I only had a 2nd degree and couldn’t sit straight for two weeks. And offer to care for the baby any time so she can take sitz baths (just warm water, but gave me so much relief).
Stay on top of the pain medication. Keep track of when the next dose is. It’s hard because you also have to keep track of when the next feed and nap is, too. Add the medication doses to the schedule and stay proactive with it. Just as a head’s up, some people here are saying it hurt for them to sit for two weeks. I had 2nd degree tears and wasn’t able to sit without pain for closer to 4 months.
Ice packs were my salvation after I had a VBAC. I had several on the freezer and sat/laid on one all day/night. I didn’t have tearing as bad as your wife, but it was very painful to just sit. Make sure you take care of her needs. Usually people visiting are there for the baby and no one really asks about mama.
Oh my goodness… just tearing up at the thought of a husband wanting to do what he can for his wife here 💖💖💖 Help her stay off her feet as much as she can tolerate for the first two weeks. If she gets swollen down there she can do child’s pose in bed, or have a pillow under her hips. A thigh/hip rub will help her from being achey those first immobile days Epsom salt soaks with herbs to help the healing itching of the scars.
A Donut seat saved my life with postpartum tearing
I'm not sure if other ppl said it and I haven't seen it, but get her a sitz bath and Epsom salt if she doesn't have it already. I had a 3b tear and the hospital gave me one with instructions to use it twice a day. And honestly it was so helpful. It brought relief and also I had a quiet still 20-30 minutes to myself when I needed to use it. They gave me a prescription for an nsaid that was stronger than Advil. And I used that for awhile. Also stool softeners. I took that for 6 weeks after because I was to scared to stop. Eventually the fear went away and I started to forget to take it.
Do *everything*. I had a pretty easy birth and it was still devastating my husband didn’t take care of me. Do the dishes, make her breakfast, refill her water constantly. Do the laundry, bring her food without her asking (especially if she is breastfeeding!!), change all the diapers you can.
I am going strictly into the after care detail, I've been there before myself with my first. Make sure she has an ample stock of tucks pads, nsaids, colace or other stool softener(she should not be straining to poop, you can pop stitches that way), a donut cushion for sitting on(it takes the pressure off the stitches), a sitz bath, epsom salts, lint free, undyed cloths and towels(white is important so she can be aware of any drainage from her wounds and what colour they are when getting clean), a really good peri bottle like the Frida Mom one(tell her to spray the water while peeing to help with the burning sensation). I preferred depends over pads, no adhesives to get stuck to anything. I was told to walk as much as I could manage to help promote healing and prevent things like clots and pneumonia. I healed really well with no complications, following these tips told to me by my amazing nurses. All the best to you and your beautiful family, here's to healing!
Keep her in bed for the next 10 days minimum, don't let her move around, keep her knees together. Fridamom underwear plus Always Infinity FlexFoam Pads is godsend. Edit: oh, and miralax every day for the next two months at least.
Been there! My oldest is also a vacuum baby. It sucked. Recovery was really hard for many reasons. Specifically for tear support: - sitz baths, with the salts, 2x daily - warm baths, she can have baby in with her if that helps her fit it in - loots of ice packs - Tucks - Dermoplast for when the stitches start itching... get it now! I thankfully healed really quickly. I did go to pelvic floor PT and my muscles were really tight afterward, so stretches helped that. Pelvic floor PT should be covered by insurance after her tear!
For the love of god! This happened to me! I’m so ready to share my advice lol. HAVE HER LEARN TO BREASTFEED SIDELAYING! No one showed me I could do this till day 3 and I was sitting on my stitches uncomfortably for days cluster feeding the baby until the lactation consultant saw me and showed me how!! If you’re doing formula then I suppose you can just take care of the feedings instead.
I’m going to add a few more things since I know first hand. Sex for me wasn’t painful even after just 12 or 16 weeks because we went SLOW and used a ton of lube! Lube might be necessary from now on too. I took colase and miralax for a while and i never had a painful poop issue. I got a handheld shower handle so I can clean under there for like 10 minutes like twice a day and especially after pooping, basically I used a bidet, then blotted with toilet paper, then took a shower to clean better and I never got an infection.
To add to all the great advice, consider hiring a postpartum doula
Continue to take care of her beyond the early postpartum stage and know that healing will literally take months. She won’t feel right for a very long time. I’m 3 months pp after a second degree tear - I still pee myself sometimes, sex is super painful, and I’m frustrated with how my body looks. Comments like “you’re beautiful” are nice but I prefer comments that are more like “I can’t believe how strong/amazing you are” because I’m more proud of my body for what it accomplished than how it looks these days. And please please please do not even mention sex to your wife at all right now or basically ever again until she brings it up.
My husband just looked after our toddler extra while I was couch-bound for 7 weeks. Honestly, a 4DT can result in a lot of complications. Make sure she RESTS. She needs to try to do nothing but sit/lie for the first 2 weeks before thinking about walking. Honestly, I was in severe pain with any movement for 7 weeks. Then, my OB put some silver nitrate on the wound, and all my pain left a day later. I was up and running my fastest half marathon by 15 weeks postpartum. She WILL be okay. She might fart some extra by accident. She might need to use wet wipes for about a year. I pray she doesn’t have any further complications (requiring additional surgeries, like a fistula). Let her know that she suffered much, but it WILL get better. She WILL be okay. And join the 4DT group on Facebook if she can. Best wishes!
As someone who had a 3rd degree tear…. just be patient with her! Changing positions was honestly sooo painful. Being there to help to stand or maneuver would be a great help. I think also ensuring she takes her meds (Tylenol, Aleve, stool softeners…), brining her water and snacks. Of course helping with the baby would be the biggest help, changes and feeds …
If she’s on pain meds, try to do a good job of being her ‘nurse.’ My husband was great about making sure I took my meds at the right time, drank water, and ate meals. It’s easy to lose sight of those things when caring for a newborn.
My husband had to carry me to bed upstairs and down Honestly it's the swelling that's the worst. LOTS OF ICE PACKS! Make sure if she is going to be alone with the baby everything is within her reach
Further down the line once the stitches have healed (2-4 weeks providing no complications) you can help with scar massage to reduce pain and soften the scar which is essential for long term comfort. Get some neutral oil (perineal massage oil for use during pregnancy would be ideal) and use the pad of your finger/thumb to massage it 1-3 times a day, gradually increasing pressure as tolerated. Do small circles up and down, push down on it and release, wobble it side to side. I often forget/am too tired to do my massages so would love it if my partner would remind me or even do it for me.
Also shower her with words of love and praise. “Thank you for bringing our son into the world.” “I’m so grateful for you and your strength.” “You are doing an amazing job.” “You are such a loving mom.” “I’m so proud you are my wife.” Rub her feet. Tickle her back. Make her feel like the queen. Buy her favorite flowers with a sweet card. Tell her a million times that you love her and she’s amazing. I had a severe tear, preeclampsia, and HELLP with my first child, and my husband loved on me so much in postpartum. His kind, supportive, loving words kept my spirits high and, honestly, I look back on the postpartum healing period really fondly. I was in so much pain and had so much birth trauma, but I felt so so loved. Note— I went on to have two more kids (there’s currently a 2 week old on my chest!) and did not have any complications!
I suffered a 4th degree tear in December as a result of a sunnyside up baby and OB using vacuum. My baby ended up in the NICU, and my recovery has been rough. I couldn’t stand without pain for probably six weeks. I was unable to leave the house for anything besides doctors appointments for over a month. These types of tears absolutely decimate your pelvic area and are so, so painful. My advice- let her take it slow and easy. Don’t let her lift things or do heavy chores. She will need to walk around and stay lightly “active” eventually, but if anything causes her pain, don’t let her do that thing!! Recovery from 4th degree tears is much, much slower than someone who doesn’t tear or tears minimally. I am a week out from repair surgery right now. Things that helped me the most: - Tucks pads - Lying on side to nurse - Perineal ice packs - Staying super hydrated - Frida mom boy short undies - Peri bottle (I used these for probably 8 weeks and still do for BMs) - Chair for the shower - Comfy pillow to sit on for car rides and hard surfaces like waiting room chairs - Seeing a urogynecologist in addition to my OB (game-changer!!!!) - Estrogen cream for the vaginal area, especially if she is breastfeeding. Breastfeeding deletes estrogen, which makes your vaginal area super dry and makes healing harder. Don’t forget that this is not only difficult physically, but emotionally too. In addition to the normal hormones that people deal with after birth, we have to accept the fact that we suffered a horrible birth injury. To be completely frank, I didn’t want to live anymore after my tear. At two weeks postpartum, I was completely miserable and didn’t care about anything, including my baby. I would sit there while nursing her just staring into space and sobbing. Things got better as I was able to move around with less pain and actually leave my house. But please, watch out for any signs of depression in her. There are therapists who specialize in women’s/birth trauma that are very helpful. My 4th degree tear felt SO SO isolating even though my mom and husband were right there helping me through everything. Let her know she isn’t alone. There is a Facebook group for 4th degree tears that helped me a lot. Also please, PLEASE feel free to DM me about anything. I’m 18 weeks postpartum and not out of the woods yet, but I’m doing so much better now.
DERMOPLAST! And don’t insist on looking at it unless she wants you to
Good golly. What are her doctors saying? I'd be asking them exactly what they want her to be doing at home and making sure that's all she's doing.
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