Granular Tissue in the Vaginal Wall— What To Do About That?
Granular tissue is a type of tissue with contractile properties that forms in tissue healing that is prolonged. For example, if part of the vaginal wall tears during childbirth, and the edges of tissue are not sutured (surgically repaired/approximated), then granular tissue will form and close the wound from the deepest layer first. This tissue is often tender/painful, inflamed and has many capillaries or dense blood flow.
It is incredible that our tissues are capable of healing the vaginal wall through this tissue growth, however, the slowed healing and tenderness of the tissue may contribute to vaginal pain and discomfort.
To support healing of these tissues, rest, nutrition, hydration and stress management are all important. If a post-partum person is chest feeding or pumping, then keeping up with the body’s need for replenishment of nutrients and rest is even more important. I have seen this slowed healing present in bodies that are under-fed, under-hydrated and under-slept— in general under-supported.
Unfortunately maternal health is not supported through our country’s politics, nor monetarily. So post-partum people often do not have adequate resources, paid-leave, childcare, and physical healing support in a time that the body really needs these basic human rights for care.
The message one could take from this is that birthing people’s recovery does not matter— and I urge you to NOT take this into your body as truth. It is a lie. Your healing matters. In fact— it matters the most!
Here are some ways you can prioritize your own healing in the postpartum period:
Take a bath before bed. Just as we wind our babies down with a comfort routine before bed, your body would benefit from this nightly routine as well. Maybe use epsom salt or healing herbs. ( I recommend Peri Soak) This floating bath supports tissues healing, nervous system relaxation, and therefore muscle relaxation necessary for rest.
Drink plenty of water. It is often recommended to drink half your body weight (in pounds) in ounces of water. For example, I weigh 190 pounds, and therefore should be drinking 80 ounces of water daily. Now if you are producing milk, add the water necessary for that on top of that number! Wow that is a lot of water… yep! You need this much for your hydration.
Allow rest. Many doulas and midwives in my community tell their postpartum peeps to rest or sleep whenever baby is sleeping… that is not wrong. Your body needs rest to heal just as much as your baby needs rest to grow! I recommend Yoga Nidra as a rest practice as it helps your brain enter healing wave lengths and patterns. Try Insight Timer and search for guided meditations on Yoga Nidra.
Pelvic Physical Therapy: In one session we can determine if your muscles are needing active or relaxation types of exercise to support healing. You may also need to be referred for a fitting of a pessary which is an internal support device. You may need internal tissue manual therapy to support healing or there may be some stored trauma that needs attention and a chance to integrate to support healing.
Cauterization. If the granular tissue continues to be a source of pain and discomfort, you can ask your OBGYN to cauterize the tissue, meaning they will use a chemical to burn off the tissue. Make sure your physician uses a topical lidocaine gel or injection prior to removal of the tissue. This is a simple outpatient procedure, that may result in minimal spotting for a day or so following the treatment. Please discuss with your OBGYN if this is appropriate for you.
Legs up the wall. If your pelvis is feeling like is could use some support, try lying with a pillow under your sacrum and your legs supported up on a wall. Allow your breath to deepen and massage in the inside of the pelvic bowl and imagine you and your pelvis being held and supported by all the people in your life who love you. Allow yourself to receive the message that your healing is the most important, and your pelvis is in fact loved and supported by many.
Witnessing and being a part of your healing helps me remember that my healing too is valuable. If I didn’t prioritize my own rest, hydration, and stress management, then I wouldn’t be available to help all of my clients. So I don’t take in the messages from systems that say anything to the contrary.
You are so so loved. And your pelvis is held up by all of us.