Perineal Care After Birth: What You Need to Know for Healing and Comfort

After the incredible experience of childbirth, it's important to remember that your body needs time and care to recover. The perineum— the area between the vagina and anus— can be especially sensitive after a vaginal birth, particularly if you have stitches as a result of tears or an episiotomy. Proper perineal care after birth is essential for easing perineal discomfort, preventing infection, and supporting your body’s natural healing process.

Read below to learn more about effective vaginal care after birth, products that can aid recovery, and essential tips for taking care of your body as you heal.

Understanding Perineal Tears and Episiotomy

During vaginal delivery, the perineum can tear as it stretches to accommodate your baby. There are several types of perineal tears, ranging from superficial skin tears (first-degree) to more severe tears that affect the muscles and tissues around the rectum (third- and fourth-degree). In some cases, your healthcare provider might perform an episiotomy—a small surgical cut made to widen the vaginal opening.

• First-degree tears affect only the skin and may not require stitches.
• Second-degree tears involve both skin and muscle and usually require suturing.
• Third-degree and fourth-degree tears are more extensive, requiring specialized suturing, often in an operating room.

Your midwife or doctor will assess any damage after birth, explain the type of tear you have, and discuss if stitches are necessary. Stitches are dissolvable and will typically disappear within 10-14 days. During this time, proper after birth care is crucial for minimizing discomfort and promoting healing.

Managing Pain and Discomfort

Pain and soreness are common in the perineal area after a vaginal birth, but there are several ways to manage discomfort and accelerate healing:

• Ice Packs and Cold Therapy: Applying instant ice packs or reusable ice packs to the perineum in the first few days can significantly reduce swelling and numb pain. Be sure to limit application to 10-15 minutes at a time.

• Witch Hazel Pads: Placing chilled witch hazel pads between your sanitary pad and perineum can provide cooling relief. Witch hazel has natural anti-inflammatory properties that soothe irritated skin.

• Pain Relievers: Over-the-counter pain medications like acetaminophen or ibuprofen can help manage soreness. Always consult your healthcare provider to ensure these are safe, especially if you’re breastfeeding.

• Pressure Relief While Sitting: Sitting down can be uncomfortable for the first few days after delivery. Use a pressure-relieving cushion or two rolled towels under your buttocks to keep pressure off the perineum. Avoid sitting for long periods, and try lying on your side whenever possible to reduce strain.

Maintaining Perineal Hygiene

Keeping your perineum clean is critical to avoiding infection and promoting healing. Here’s how to maintain proper hygiene:

• Peri Bottle: After using the bathroom, a peri bottle filled with warm (or cool) water can help clean the perineal area gently without the need for wiping, which can irritate stitches or tears. Spray the water from front to back to avoid introducing bacteria from the rectum into the vaginal area.

• Shower or Bathe Daily: Take a warm bath or shower once a day to clean the area. Avoid using soap, bubble baths, or shower gels directly on the perineum as these can cause irritation. Instead, use plain water for cleansing.

• Change Sanitary Pads Frequently: Change your pads every 4 hours to reduce the risk of infection and to keep the area dry. Opt for soft, breathable pads. In the first few days after birth, disposable underwear can help.

Bladder and Bowel Care After Birth

Bladder and bowel care are key components of vaginal care after birth. The trauma from delivery can sometimes make it difficult to urinate or have bowel movements without discomfort, but these tips can help:

• Bladder Care: If it stings when you urinate, use the peri bottle to spray warm water over your perineum as you go.

• Bowel Movements: It’s common to feel nervous about your first bowel movement, especially if you have stitches. To reduce discomfort, hold a clean sanitary pad over your perineum for support. Drink plenty of water and eat fiber-rich foods to keep your stools soft. If you’re struggling with constipation, ask your healthcare provider about using a stool softener.

Pelvic Floor Exercises for Recovery

After delivery, your pelvic floor muscles may feel weakened due to the strain of pregnancy and childbirth. Postpartum physical therapy is vital for preventing issues like urinary incontinence and promoting overall recovery. Postpartum exercises such as Kegels help tone your pelvic floor muscles. Start by imagining you’re trying to stop the flow of urine, then gently squeeze and lift the muscles. Hold for 3-5 seconds, relax, and repeat 10 times, three times a day. Doing Kegels not only helps with bladder control but also increases blood flow to the perineal area, speeding up healing.

Additional Tips for Postpartum Healing

In addition to perineal care, your body will benefit from these additional recovery strategies:

• Cold and Warm Therapy: Alternating between cold ice packs and warm sitz baths can provide relief. Cold reduces swelling, while a warm bath can soothe soreness.

• Proper Clothing: Wear loose, breathable clothing and avoid tight pants or jeans that may irritate your perineum. Letting the area “air dry” when possible can also help promote healing.

• Postpartum Checkups: Schedule a follow-up appointment with your healthcare provider within 2-6 weeks after delivery. They will check how your stitches or tear are healing and assess your general recovery.

What to Watch for and When to Seek Help

It’s important to monitor your recovery and be aware of potential signs of infection or complications. Contact your healthcare provider if your perineal area becomes swollen, red, or produces an unusual odor, your stitches feel like they’ve opened or aren’t healing, you experience severe pain that doesn’t improve, or you develop a fever or flu-like symptoms.

Early intervention can prevent more serious issues and ensure you heal as expected!

Vaginal Care After Birth is a Vital Part of your Recovery.

From using ice packs and peri wash bottles to strengthening your pelvic floor with Kegels, there are many ways to promote healing and ease discomfort. Don’t hesitate to reach out to your healthcare provider if you have any concerns about your recovery. With the right care and support, you’ll feel better in no time and be able to fully embrace your new role as a mom!

Sources

https://www.cuh.nhs.uk/patient-information/perineum-care-after-childbirth/

https://www.mkuh.nhs.uk/patient-information-leaflet/perineal-care

https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/postpartum-care/art-20047233