PERINEAL CARE USING SITZ BATH4 August 2020
Did you just deliver a baby and you are feeling sore or discomfort around your vagina? Did you sustain some laceration during delivery? This is for you if your answer is yes. The perineum is the area around the vagina excluding the anus. Care of both the perineal and anal region is very important for all women and not only those who just had a baby. Using a tissue paper is ok but washing with water is great after urinating, sexual intercourse and defecating. The care of these regions is very important after delivery especially if you had a couple of stitches to repair the injury caused by the baby as it passes through the vagina. This will help prevent infection and opening of the stitched wound.
Sitz bath is a bath in which the buttocks are dipped up to the level of the hips in water. It is can be done using warm, cool or alternating between a warm and cool water. Salt, vinegar or baking soda can be added to the water or the water can be used alone. For the purpose of caring for the injury in the vagina and around, I will be describing how to do a warm sitz bath using salt. The laceration in and around the vagina might be sustained accidentally as the baby passes through the vagina or intentionally made by the midwife or obstetrician to widen the vagina opening for easy passage of the baby and this is called an episiotomy. After every delivery is completed, the vagina and the area around it is inspected for any laceration and stitched. If an episiotomy is given it is also stitched. The thread used for stitching can be damaged by heat resulting in opening of the wound which will require a second application of stitches. If you were stitched after delivery, do not let hot water get to the area. Yes, that’s what you just read, I know this is the opposite of what you thought or must have heard some folks say. If the bathing water is too hot, do not use it, you do not have to announce to the neighborhood when it is time for your bath as a result of very hot water being used.
CATEGORY OF WOMEN WHO MIGHT HAVE AN EPISIOTOMY
Episiotomy is a deliberate incision made on the vagina mucosa, perineal muscle and skin to widen the vagina to ease the passage of the baby. It’s more controlled compared to when the tear occurs accidentally as the baby is delivered which is more likely to be rugged and extensive. It is important to note that episiotomy is not routinely given until there is an indication for it. So, don’t be scared you might not need one however, the following category of women are more likely to have it;
- When the perineum is tight and threatening to tear
- Women with severe female genital cutting/female circumcision
- When the baby is big
- Previous scar that is threatening to tear
- Delivery of a baby coming with the buttocks
- When an instrument is to be used to assist the delivery example a vacuum or forceps
HOW TO PREPARE AND HAVE A SITZ BATH
To prepare a sitz bath, you need a lukewarm water in a receptacle either a bowl, bath tub or bidet. There are bowls that can fit on the toilet for this purpose or even electronic bidet that can be connected to the toilet. Add salt to the water until it becomes highly concentrated that the salt no longer dissolves easily as you add it to the water. Sit in it for about 15- 20 minutes 2 to 3 times a day. It should also be done after defecating. Ensure that the temperature of the water is comfortable enough for you and not hot as it will affect the stitches.
BENEFITS OF SITZ BATH
- It has a soothing effect
- It increases blood flow to the perineal region which helps with healing
- Helps to reduce swelling
- Helps to reduce pain
- It has an antiseptic effect
- Prevent infection at the site
- Keeps the area around the wound clean
WHO CAN USE A SITZ BATH?
Apart from women who just delivered, sitz bath can also be used in the following conditions;
- Hemorrhoids before or after it’s operated
- Bartholin’s cyst
- Anal surgery
- Vaginal surgery
- Vaginal infection
DOES IT HAVE A SIDE EFFECT?
It is rare to have any unpleasant effect from doing a sitz bath. However, one could rarely feel dizzy or the heart might be beating too fast. This might be as a result of an increased blood flow due to the dilation of the blood vessels caused by the warm water at the perineal region.
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