Having a baby is an amazing and life-changing experience. However, many women sustain tears or need episiotomies during vaginal delivery which require stitches. These stitches take time to heal completely. So how long do stitches take to heal after giving birth?
Quick Answer
On average, it takes 2-4 weeks for vaginal stitches from birth to fully heal. However, some stitches dissolve within a few days while more severe tears can take 6 weeks or longer to heal completely.
What Causes Tears and Stitches During Childbirth?
During vaginal delivery, the vaginal opening must stretch widely to allow the baby to pass through. This stretching can cause tears in the perineum (area between vagina and anus) or vaginal wall. Tears are classified into four degrees:
- 1st degree – Small, skin-level tears of the perineum
- 2nd degree – Deeper tears into the perineum muscles
- 3rd degree – Tears extending down to the anal sphincter
- 4th degree – Tears extending into the anal canal or rectum
Sometimes, an episiotomy is performed during delivery. This is a surgical cut made at the vaginal opening to widen it and facilitate childbirth. Whether from tears or an episiotomy, stitches are required to close these wounds.
Healing Stages of Vaginal Tears and Episiotomies
The healing of vaginal tears and episiotomies occurs in three overlapping stages:
Inflammatory Phase
This initial phase starts immediately after birth. The wounded area bleeds, swells and becomes painful. White blood cells rush to the site to prevent infection. The mom experiences postpartum vaginal discharge (lochia) which can irritate the stitches.
During this phase, care should focus on keeping the area clean and promoting healing. Sitting in a bath with warm water can provide comfort. Ice packs can ease swelling. Pain medication, skin anesthetic sprays and numbing creams relieve discomfort.
Proliferative Phase
In this phase, new tissue forms to mend the wound. The edges of the tear or cut knit back together. New blood vessels develop. Swelling continues to go down. Discomfort decreases but some tenderness around the stitches remains.
Continue with sitz baths and topical pain relief measures. Keep the area dry to prevent infection. Use peri bottles or squirt bottles of water to clean yourself after using the bathroom. Pat gently, don’t rub or wipe.
Maturation Phase
This phase focuses on strengthening the repaired tissue. Collagen fibers realign along tension lines and the wound regains tensile strength. Swelling goes away completely. The stitches begin dissolving (if dissolvable type used) or can be removed.
As the wound finishes healing, you can resume normal activities. But continue gentle care of the area when using the toilet. Avoid exertion or activities that put pressure on the perineum like bike riding.
Factors that Affect Healing Time
While 2-4 weeks is the average, many factors influence how quickly or slowly vaginal tears and episiotomy stitches heal, including:
Degree of Tearing
- 1st degree tears – Often heal within 5-10 days
- 2nd degree tears – Take 2-3 weeks to heal
- 3rd and 4th degree tears – Can take over 6 weeks to heal
More extensive tears through deeper layers of vaginal tissue take longer to mend.
Type of Stitches
- Dissolvable stitches – Absorb within a week or two
- Non-dissolvable stitches – Require removal around 5 days postpartum
Dissolvable sutures disappear as the wound heals. Non-dissolvable stitches must be removed once the tear has begun to mend.
Medications and Supplements
Certain medications can slow healing:
- Steroids
- Non-steroidal anti-inflammatory drugs (Motrin, Advil)
- Anticoagulants
- Immunosuppressants
Supplements like vitamin C, zinc and bromelain may help speed up recovery time.
Age and Health Condition
Younger women typically heal faster from birth injuries than older women. Chronic health conditions like diabetes or obesity can also delay healing. Smoking inhibits wound repair.
Genetics
Genetic factors affect wound healing abilities. For example, people whose ancestors are African American or Asian often have more scar tissue formation which can prolong recovery.
Wound Infection
An infected episiotomy or vaginal tear prolongs the inflammatory phase. Seeking medical care for signs of infection like fever, discharge or worsening pain is important.
Stitch Pain and Care Tips for Faster Healing
To help your stitches heal as quickly and comfortably as possible:
- Take sitz baths in warm water several times a day
- Use ice packs to relieve swelling
- Try topical anesthetics and cold compresses to ease pain
- Wear loose fitting clothing and cotton underwear
- Drink plenty of water and eat a balanced diet
- Avoid activities that put pressure on the perineum
- Gently pat dry instead of rubbing after using the bathroom
- Try natural remedies like aloe vera, tea tree oil or coconut oil
- Discuss non-constipating stool softeners with your doctor
See your OBGYN promptly if you have signs of infection like fever, foul smelling discharge, worsening pain, or if stitches come apart.
When Can I Resume Normal Activities After Stitches?
Here are general timelines for resuming regular activities after vaginal tears and episiotomy:
Sex
Wait at least 6 weeks until your OBGYN confirms stitches have healed. Even then, use lubricant and go slow to avoid re-injury.
Exercise
Start with postpartum exercises like pelvic floor training and gentle yoga after 2 weeks. Avoid high impact exercise for 4-6 weeks.
Work
For an office job, you may return in 2-3 weeks. Take more time before resuming heavy lifting or hard labor.
Driving
Generally 1-2 weeks for short distances. Wait longer if pain could inhibit braking or focus.
Signs of Improper Healing
Contact your doctor if you notice:
- Unusual swelling, redness or discharge from the stitches
- Increased pain or tenderness at the tear/episiotomy site
- Bleeding from the vagina
- Foul odor coming from vagina
- Edges of tear appearing separated
- Feeling of stitches coming apart
- Fever higher than 100.4°F
These could indicate infection or that stitches have become unaligned and may need medical correction.
Conclusion
Healing from vaginal lacerations and episiotomies is a gradual process. Maintaining cleanliness, eating well and avoiding pressure on the area will facilitate mending. For extensive tears into deeper tissues, recovery can take over 6 weeks. Patience and care is needed to allow your body to properly repair itself after the physical trauma of childbirth.