The New Intimacy

Sex after difficult delivery - still experiencing pain 13 months later

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Contributor: Munko Munko
I had my daughter almost 13 months ago now. It was a long (26 hour, 24 hours "active") labor. I ended up pushing for 3 hours, and eventually having an assisted delivery with forceps and an episiotomy. I also ended up with a prolapsed rectum (sounds awesome, right?!)

I still experience tenderness and pain around my episiotomy site, and some positions are still quite difficult to do without a lot of time and easing in to it. It feels like I was stitched up to tightly. I also experience soreness/tenderness inside my vagina as well, at times while having sex. I've had two paps and exams since birth, so I know it's nothing major...but, will it ever go away?

I have another appointment with my OBGYN next month, it's been 6 months since I was last checked out, so I'll be bringing it up again and we'll go from there, but I'm just wondering if anyone has any experience/thoughts on the matter?

I have heard that physiotherapy can help, has anyone tried it and had success?
03/15/2013
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Contributor: P'Gell P'Gell
Yikes! Did you have a 4th degree tear or an episiotomy equivalent to that? (I'm guessing with forceps you did.) Rectal prolapse is horrible! Did you tear that far, too?

Are you using a good quality lube, no glycerin, no parabens, NO "warming" "cooling" "tingling" lubes, NO flavors, or dyes in it? High quality lube can make a HUGE difference. Sliquid or LELO make good lubes with few irritating ingredients. It really can make a huge difference, IMO, KY is a chemical dump "lube" and I wouldn't put in on or near my vagina or butt. (Same goes for most ID and ANY flavored or "enhanced" lubes. A lube in your situation should be ONLY for lubrication, with NO ingredients that are not needed only for lubrication.

Good positioning can make a difference, too. I found rear entry, lying on our sides the least painful after pregnancy. That and a LOT of oral sex for you before hand so you will lubricate and even orgasm first. There shouldn't be any rush to get to PIV. (I had a 56 hr labor, 3.5 hours pushing and then a C Section with my first. My doc said he'd "wreck" me if he tried a forceps (my baby was still at the Zero Station same with my second. After this we simply decided on a C Section for the third.) So I agreed to a section after 2 and a half days of labor. I do have some patients who have had simply extreme episiotomies that needed time to heal, but a year is a long time.

You need to have a doctor or a good midwife look at you and figure out why you are still in pain. It could be a lot of things. (I'm a Maternal Infant Nurse and a Lactation Consultant, so I deal with this stuff a lot.)

If you are still breastfeeding, you can't use any estrogens. But, if your baby has weaned himself, then trying an estrogen cream can sometimes help with natural lubrication, tissue thickening and help you stretch properly without hurting. In severe cases, a short surgical procedure may be necessary. I know of no physiotherapy that can help this, unless there is scar tissue, but there are varying opinions on how to deal with scar tissue that is causing pain.

I'd talk to your OB. (Or find a good midwife.) IF he doesn't take you seriously or says it "because" of breastfeeding (which is bullshit) or won't do anything see somebody else! You have a right to have fun, enjoyable sex, and your doctor should investigate why you are still in pain and FIX it. (He was the guy who forceped you in the first place, it's the least he could do.)
03/15/2013
Contributor: Airen Wolf Airen Wolf
(EF Review Program Mentor)
Quote:
Originally posted by Munko
I had my daughter almost 13 months ago now. It was a long (26 hour, 24 hours "active") labor. I ended up pushing for 3 hours, and eventually having an assisted delivery with forceps and an episiotomy. I also ended up with a prolapsed rectum ... more
Sounds like you had a really rough delivery! It could be that the tissues have scarred a bit more than usual and scar tissue doesn't stretch as easily. I would definitely talk to your OBGYN and if you get blown off seek another opinion. I do know that silicone is used to ease scar tissue and that we have used actual silicone lube to ease some of Sigel's keloid scars so maybe you could try using a good quality silicone lube and sort of massaging the lube into the tissues. This would be great for you and your partner!

It took quite a lot of time for me to stop hurting after the birth of my second child so I do believe it's pretty common after an episiotomy to have some scaring and pain.
03/15/2013
Contributor: Munko Munko
I'm not sure what "degree" my episiotomy was equivalent to, but it did take over 6 weeks before I could walk or sit properly without excruciating pain (I also had a large hematoma from the inside of my vagina all the way to my left butt cheek, through to the bone...that was more painful than any of it!). As far as I know they didn't cut me right through and I didn't tear right through to the rectum. But, to be honest...no one told me about the hematoma until I went to have my stitches checked because it felt like I split them open...but it was just the hematoma, so I could have torn badly as well, and no one said anything. I remember asking if I tore, because I had specified no episiotomy initially, and that's when they told me the delivering OB had cut me so I wouldn't tear butt to bellybutton!

I only nursed for 4 months, I had retained placenta and something hormonal going on (that they couldn't figure out) and a uterine infection. Despite domperidone, pumping round the clock, SNS, nothing happened and my little stubborn child refused formula at that point, so we had no choice...but while nursing, I did have vaginal atrophy. But that seemed to clear immediately as soon as my cycles returned, but maybe my hormones are still off? I'm not entirely sure.

We do use silicone lube, and a high quality one, we haven't bought "grocery store" lube in years and years. Only the good stuff - I can't remember what brand we're using now, but I know it's just plain, high quality silicone..no cooling or warming, etc. Massaging might be an idea, worth a try anyways!!

I actually find side lying and rear entry most painful on my scar tissue, but missionary most painful internally. The internal pain isn't too bad, but it's definitely there from time to time and it never used to be.

I will make sure to seek another opinion if my OB doesn't take me seriously. I haven't seen him since my daughter was 6 months, and at that point because I had so much happen in those few months he wanted to wait and see if it just needed more time. But, I've had enough waiting!

Thank you both for your input!!
03/15/2013
Contributor: Munko Munko
Here's my update as promised

I have very tight scar tissue, and have been given a anesthetic gel to put on the scar before sex and we are supposed to have more sex in all positions to help stretch the scar tissue out and loosen the tissues.

Additionally the ligaments supporting my upper vaginal wall are very tight and the source of my internal pain. So I have been referred to physio therapy which will help the ligaments as well as the scar tissue. Hopefully it works!!
05/08/2013