Unsutured second degree tear

Body: 

Hello everyone, I have a second degree tear following the birth of my second baby 11 months ago that was not sutured. Is repair of the perineum regarded as surgery if everything else is left as is? Amy

Hi Amy,

Yes indeed, a perineoplasty is a surgical procedure. Your question speaks to the heart of perhaps the single most significant issue concerning the health of the pelvic floor (I grit my teeth every time I have to say

Thank you so much for your reply. It's the info I need to help consider my choices - I have been trying to get a few stitches since day 4 after birth but no doctor wants to touch me as I am still breastfeeding and they describe me as severely hypo-estrogenic. I tore naturally as I did in my first labour but refused stitches this time as I had no faith in the midwife. My story is long and not for today - I will share more soon.

A urogyn describes me as having "a very deficient scarred perineum where 2 degree tear was not sutured... slight cystocele, gaping entroitus and uterus that is normal-sized, anteverted mobile and virtually normally supported. She said "you have no perineum" and told me to take estrogen pessaries (Estriol) for two months to then review. I took two weeks worth over two months - thinking I might regrow a perineum??? but have stopped because I experienced - severe cramping, mild thrush, and the start of mastitis as well as a strange taste in my mouth and also believe the changes to the skin would be temporary. The consultant at the hospital I gave birth in said she disagreed with the urogyn and that I had a perineum, said I would do myself no harm by leaving things as they are while I breastfeed two to three years as I have for my first child

Is it unhealthy for my body to be in a hypo-estrogenic state? I am sure it is unhealthy to take the pessaries. I think that I would feel better emotionally if I had a few stitches on the skin, but finding the downtime to heal again now after birth is beyond me.

My physio says woman can feel 30% improvement with prolapse once breastfeeding stops - this does not seem to agree with wholewoman.com.

I have your book. I am starting to make sense of the posture and use muscles in my legs and arms I've not thought about in 5 years.

I have a question about salt water - I avoided bathing in salt after birth, perhaps it doesn't go well with vaginal dryness. I pushed myself to go into the sea recently and it stung a bit. Should I try Epsom salts at home?

By the way, I am blessed with two beautiful daughters and a loving husband.

Amy, I just wanted to jump in that if breastfeeding is putting you in that "state" they are talking about, I can't imagine how then it is unhealthy if it is a natural consequence of breastfeeding. I assume that as nursing postpones fertility it is because estrogen is suppressed? However, I am nursing and my cycles returned right before my baby was seven months and I am about to start my 4th cycle, so my estrogen must have been released as I am fertile now? Anyway, I am so skeptical of the medical community I don't know if I will be helpful at all-- because you know they used to have women express their milk into a test tube so the doctor could hold it up to the light and tell her whether or not her milk was good enough for her infant or if she should give it formula. What non-sense! If your state is a natural consequence of breast-feeding, how can it be bad? In fact, if one has a history of estrogen fed breast cancer this suppression is what they beleive may help women who breast feed be at lower risk, is it not?

Dear Amy,

You really need better help with this than you