Your perineum is amazing.  It is designed to stretch beautifully over a baby [being born instinctively].  It is also designed to heal very nicely should a tear happen, so long as stitching doesn't exacerbate the problem.  However, many mothers are *still* suffering through unnecessary episiotomies, tears, and being stitched so tight it causes painful intercourse, future tears, and uncomfortable scar tissue.  Though many women have lovely births without tears after previous scar tissue, these scars can sometimes cause painful sensations and emotional upsets that are simply unnecessary.

The first issue is the unnecessary episiotomies.  Your skin is designed for birth, and remember an episiotomy is like a "tear here" nick on frozen veggies, typically making a larger tear than what may have happened naturally.

Secondly, women who have had an episiotomy or tear may either need stitched, or their provider thinks they need stitched.  Many tears can actually heal quite beautifully without any stitching.  In fact, it can lend itself to a better and more natural heal if left unstitched.  The issue with this method is many mothers are not supported enough after birth to lay with her baby and rest until the tear is healed.  She has to be mindful that she needs to rest and have people willing and available to do so.

Although, even if stitching is done, how it is done is quite important.  Provided there isn't uncontrollable bleeding, which is not likely, stitching can often at least wait until the swelling goes down.  The problem with stitching swollen tissue, is that swollen tissue will reduce.  And when the swelling goes down, those stitches start to pull, unless they weren't done tightly - in which case, were they even needed to begin with?

Sutures are not designed to heal the wound.  They are designed to hold the tissue in place so new tissue can form and heal the opening.  Alternative methods to sutures include plantain - the amazingly useful weed found in almost everyone's backyard (and driveway).  Plantain also has properties to speed healing, so it works on multiple levels.  (FYI - it is also very nutritive and can be blended in smoothies, chopped into stir fry, or brewed for a tonic tea).  You can read here for a variety of other herbs than can be used to speed healing, also.

If you've found yourself in a situation where you have experienced a tear or episiotomy, and you have uncomfortable sensations around the scar tissue, the best remedy I've found for healing the skin is evening primrose oil (EPO).  Evening primrose oil is often used internally for skin health and to boost GLA levels (which helps with prostaglandin production) in for women's health during menses, for PMS, through the menopause years, and more.  However, it may be beneficial for healing perineal scars (and has its uses for cervical dilation in the cases of cervical damage caused from D&C or LEEP procedures).

Let me make myself clear.  I AM NOT ENCOURAGING THE USE OF EPO FOR ANY METHOD OF CERVICAL RIPENING OR INDUCTION.  An induction, is an induction, is an induction.  THERE ARE NO "NATURAL" INDUCTIONS. PERIOD.

If you're pregnant and considering this, be cautious and do your research on evening primrose oil. Don't go blindly into making choices for the health of you and your baby.

OK, we clear?  Have people used this, yes?  Has it caused complications?  Probably, maybe, who knows?  Has it been beneficial?  Probably, maybe, who knows?   Your baby will come when your baby and your body are ready.  You and your healthcare provider may find it beneficial in your situation.  Your research may lead you to believe it is unsafe for your specific situation.  Baby needs time to rotate for a smooth birth.  Mom needs time to feel safe for a smooth birth.  Baby needs to come spontaneously...  it is AMAZING what a few extra days in the womb can do for breastfeeding - hormonally and physically.  OK, I could go on....  but hopefully you get my point.  Make the choices that support biological birth so that you have the peace and space for baby to come when you're both ready, and make informed decisions.

Back to EPO for scar tissue relief.  If you find that intercourse is painful after perineal damage (breastfeeding reducing your lubrication aside), or you feel like you have been given a "husband's stitch" (where the doc. stitches you tighter to help please your husband.... wow, that provider doesn't know about physiology, do they?... though this can be caused unintentionally, also, because of swelling).  If you find that sitting or walking is painful after perineal damage.  Or any other discomfort that seems to be resulting from external scar tissue (on the perineum or not).  Try evening primrose oil.  Grab a good brand of about 1300mg of evening primrose oil gel caps.  Or, better yet, get it from your local herbalist or online at somewhere like Mountain Rose Herbs).  After you've cleaned up in the shower, grab one capsule.  Break it open into your hand.  Put a little on your fingers, and just gently rub over the scar tissue - don't rinse.  You may find that perineal massage is beneficial, but I've not found this necessary.  Just simply rubbing the EPO on the scar tissue like ointment seems to work just fine. Wash your hands and get out of the shower; you're done.  Do this daily until your scar tissue no longer causes you discomfort.  2-4 weeks seems to be a common time frame of noticing relief.

If you have tried this - please provide feedback on your experience!