1) Stitches after birth
Q. I hate the thought of needing stitches after the birth. What’s the best way of avoiding this?
A. Massaging the perineum (between the vagina and the anus) with natural oil, such as wheat germ or almond oil, may reduce the likelihood of tearing. It’s best to start this at around 34 weeks of pregnancy and to do it every day for a couple of minutes.
Get into a comfy position and gently massage the area with clean fingers. Put one or two fingers just into the entrance of your vagina, and very gently stretch down and to the sides in a ‘U’ shape, in the opposite direction of your urethra and clitoris. Also, when giving birth try to ‘breathe’ your baby out – controlling rather than pushing. An episiotomy (a cut) is more common with an instrumental birth, and the way to reduce the likelihood of this is to keep upright and mobile in labour.
2) I can’t banish bad birth memories
Q. My daughter is 5 months old and I love being a mum. But I can’t stop thinking about the birth, which felt so traumatic. What can I do?
A. Birth is a huge event and mostly a very satisfying one, but for many women it is a shock and they can feel haunted by feelings that they experienced. It’s great that you want to do something about this, as many women try not to acknowledge their feelings at all.
Approximately 10,000 mums a year in the UK suffer from PTSD (post-traumatic stress disorder) and experience flashbacks, anxiety and fear. Those around you often don’t understand, but help is out there. First, think about your feelings. Do you understand what happened during labour? Did you feel out of control? If you would find it helpful to look at your notes with a midwife, contact the head of midwifery at the unit where you gave birth. Also, speak to your GP or health visitor, as many areas have a nurse who specialises in mums’ wellbeing. There is also lots of support available at www.birthtraumaassociation.org.uk.
3) What are afterpains?
Q. I’ve heard people talk about afterpains or contractions after the birth. What’s that all about?
A. After the birth of your baby, the placenta separates from the wall of the uterus and is expelled. The uterus contracts tightly to seal off the open blood vessels on the wall of the uterus where the placenta was. These contractions are often referred to as afterpains, and can feel like crampy period pains.
Don’t worry, it’s not like going through labour all over again, it’s just nature’s way of making your uterus contract back down to its normal size and the discomfort will only last two or three days. If these pains are uncomfortable, it’s fine to take paracetamol or use a hot-water bottle or wheat bag on your stomach.
You may well not be aware of any afterpains if you have given birth for the first time, but the cramps can become a bit more uncomfortable with subsequent pregnancies, as your uterus has to work a bit harder to get back down to its original size.