How do you know if your stitches have ripped after birth?

Vaginal tears and stitches are common after childbirth, and it’s normal to feel worried about what is and isn’t normal as you heal. You may be trying to understand what a vaginal tear looks like, what healthy healing should look like, or whether your stitches may have opened. 

In this guide, we’ll explain everything you need to know about vaginal tears and how to know if your stitches have ripped as you recover.

What is a birth injury?

Birth injury refers to physical trauma that occurs to the mother during the process of childbirth. These injuries can vary in severity. While some may heal on their own, others may require medical intervention, including stitches.

Common birth injuries include tears or cuts to the perineum, the area between the vagina and the anus. These tears and cuts may occur naturally during delivery but may also occur due to an episiotomy.

What does a vaginal tear look like?

Vaginal tears vary in appearance depending on how deep the tear or episiotomy cut is, and which tissues were affected during childbirth. Most tears look red, swollen, and slightly bruised in the first few days, gradually becoming lighter in colour as they heal.

While every woman heals differently, here is what you can generally expect vaginal tears to look like:

First-degree tears

• Small, shallow splits in the skin
• Red or pink fine lines
• Minimal swelling

Second-degree tears

• A longer or deeper tear to the perineal muscle
• Swelling or puffiness around the wound

Third- and fourth-degree tears

• Deeper and more open tears before repair
• Heavily bruised
• More swollen than minor tears

How do you know if your stitches have ripped? 

You may suspect your stitches have come apart after birth if you notice increased pain, a pulling or tearing sensation around the perineum, or if the wound looks more open than before. Other warning signs of ripped stitches after birth include:

• Sudden or severe pain that wasn’t there previously
• A sharp “giving way” feeling
• Heavier  or renewed bleeding
• Foul-smelling discharge or unusual colours
• Swelling that worsens instead of improving
• Difficulty sitting, walking, or passing urine/stool due to pain
• Visible separation of the wound edges
• Redness or heat around the perineum

If you observe these symptoms or have any concerns about the healing process, reach out to your healthcare provider for a thorough evaluation. Regular postpartum check-ups play a crucial role in monitoring the healing progress, helping to address any issues that may arise to ensure a smoother recovery for new mothers.

While some mild discomfort is normal during recovery after stitches, if you think your postpartum stitches have ripped, it’s important to contact your midwife, GP, or maternity unit for assessment and advice.

What to do if you think your stitches have ripped 

If you suspect that your stitches have ripped during the postnatal period, take immediate action. Contact your healthcare provider promptly to discuss your symptoms and schedule an evaluation.

Treatment options will depend on the extent of the damage and may include:

• Re-suturing the wound
• Prescribing antibiotics to prevent or treat infections
• Providing pain management strategies
• Offering wound care advice
• Avoiding strenuous activities
• Maintaining proper hygiene

In some cases, additional tests, such as imaging studies, may be recommended to assess the severity of the damage. Open communication with your healthcare team is vital during this time, allowing for a collaborative approach to your recovery.

Remember that each case is unique, and the recommended treatments will be tailored to your specific situation. Adhering to the prescribed care plan and attending follow-up appointments will ensure comprehensive monitoring of your recovery and help prevent potential long-term consequences.

After treatment, the area will heal as new tissue grows and fill the gap where the stitches were. This new tissue may look red and may bleed slightly, but your scar will gradually fade over time.

Re-sutured wounds can heal a bit faster, but there is a small risk that it will become infected again.

How to heal vaginal stitches after birth

For effective episiotomy or vaginal tear aftercare, here are some tips you can follow:

• Keep the area as clean and dry as possible
• Wash gently with warm water only
• Allow the wound to air-dry rather than rubbing
• Change sanitary pads regularly
• Avoid soaps or perfumed products on the area
• Consider leaving underwear off at night once discharge has eased

These simple episiotomy recovery tips can support healing and improve comfort in the weeks after birth.

What are the potential consequences of ripped stitches?

One potential consequence of ripped stitches is an increased risk of infection. Ripped stitches expose the wound to external contaminants, creating an environment conducive to bacterial growth. This can result in several complications, including:

• Localised infections, such as cellulitis
• Delayed healing, leading to prolonged discomfort
• Tissue damage or scarring
• Painful intercourse
• Psychological distress during the postpartum period

Seeking timely medical assistance is crucial for mitigating potential consequences, ensuring optimal healing, and improving wellbeing for both the mother and the newborn.

How long do stitches take to dissolve after birth? 

The healing time for dissolvable stitches, also known as real episiotomy stitches, after birth depends on various factors, including:

• The extent of the injury
• The type of stitches used
• The individual’s overall health

Generally, stitches start to dissolve or are removed within 1-2 weeks. However, deeper tears may take 4-6 weeks to fully heal. 

Why are stitches needed after birth?

Stitches are often needed after birth to promote proper healing of tears or incisions and to prevent infection. However, not all tears will require stitches and this can depend on your personal circumstances.

Common injuries leading to stitches

The most common injuries leading to stitches include:

• Perineal tears
• Episiotomies (surgical incisions made to widen the vaginal opening)
• Vaginal wall tears

How often do these injuries occur and how often are stitches required?

The occurrence of birth injuries and the subsequent need for stitches can be influenced by various factors, including the birthing process itself.

Vaginal deliveries carry a risk of perineal tears, which occur in approximately 53-79% of cases. The likelihood of needing stitches is often associated with:

• The size of the baby
• Prolonged labour
• The use of assisted delivery techniques such as forceps or vacuum extraction

Episiotomies are performed in about 20% of deliveries. These intentional cuts are typically made when there’s concern about potential tearing or complications during childbirth. While episiotomies can minimise the risk of severe tears, they also contribute to the need for stitches.

How often do stitches rip?

While most stitches heal without complications, there is a possibility of them ripping. This is especially likely if the mother engages in strenuous activities too soon or does not follow proper postnatal care guidelines or hygiene practices.

The frequency of stitches ripping can be influenced by factors such as:

• The type of delivery
• The extent of the original injury

The adherence to postnatal care guidelines

How to prevent a perineal tear

A midwife can support you in avoiding perineal tearing during labour, particularly when your baby’s head begins to crown. At this stage, you may be asked to stop pushing and instead take short, quick breaths – panting or puffing through your mouth.

This controlled breathing allows your baby’s head to emerge slowly and gently, giving the skin and muscles of the perineum time to stretch and lowering the risk of tears.

While the perineum usually stretches effectively, tears are more common in women giving birth for the first time. Research suggests that perineal massage during pregnancy in the final weeks can help reduce the chances of requiring an episiotomy during birth. Most techniques involve placing one or two fingers into the vagina and applying gentle downward or sweeping pressure toward the perineum.

Evidence shows the greatest benefits occur in women who perform perineal massage daily in the weeks before labour.

Signs your stitches are healing normally

If you experience mild discomfort, this is not always a cause for concern. There are several clear signs of a healing episiotomy or tear wound, including:

• Gradually reducing pain
• Mild itching as tissue repairs
• Light bleeding that slowly decreases
• Slight lumpiness or firmness around healing skin
• Stitches loosening or dissolving naturally without pain

Seeking further help or birth injury advice

Most perineal tears and stitches heal without complications, but if you’ve experienced repeated wound breakdown, severe infection, or feel your concerns were not taken seriously during labour or aftercare, it may be a sign that something was missed in your treatment.

If you’re worried that your stitches ripped due to inadequate care, delayed intervention, or mistakes made during delivery, you may be able to explore whether medical negligence played a role. 

Our specialist birth injury solicitors can review your experience, explain your options, and let you know if you may have a valid claim. If you’d like to talk to someone about your experience, contact our team for advice.

In most cases, the doctor or midwife will make a small diagonal cut from the back of the vagina, directed downwards and to one side, to reduce the risk of severe tearing. After the birth, the cut is carefully repaired with dissolvable episiotomy stitches, which typically heal without the need for removal.

However, in certain cases – such as if complications arise – your healthcare team may recommend a repeat episiotomy to protect you and your baby.