How is it treated?
What can I do?
What is a haematoma?
Swelling of the woman's vulva and perineum is quite normal after a vaginal birth. The skin and tissue in this area resembles the tissue that can be found in the human mouth. It will swell quite rapidly and dramatically (like a 'fat lip'), but heal easily.
Occasionally, the vulva, vagina or perineum can swell because blood is collecting under the skin, (similar to a bruise). This can happen if tiny blood vessels in the vulva split during the birth (usually if forceps are involved) or the perineum has been stitched but there is a small blood vessel continuing to bleed and collecting under the stitches.
If a haematoma is occurring then the woman will notice the swelling within a few hours of the birth. Haematomas can be quite painful and make the area feel very 'full' 'dragging' or 'heavy'. Even though the genitals can be tender and sore after a vaginal birth, the haematoma will make the area feel unusually painful, with the pain continuing to increase as the hours pass.
How is it treated?
If the haematoma is under the skin in the vulva or vagina, a doctor may need to 'lance' the area gently to allow the blood to be released. This normally brings great relief.
If blood is collecting under the stitches, the caregiver may need to cut and remove the stitches, tie off or put pressure on the bleeding blood vessel for a minute or two, and then stitch the area again.
What can I do?
As the woman, if you are concerned about the amount of swelling in your vulva or the pain in the area seems unusually intense or 'full', ask your caregiver to check your perineum to make sure a haematoma is not forming. Caregivers will check the area on a daily basis if you have had stitches, but will not generally look at it more often unless you are concerned.
After the blood is released the area will normally feel much better.