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Perineal Care & Healing

Care of your perineum

Whether or not you have had stitches, your perineum (the area between your vagina and rectum) will need some TLC. Treat it like an athletic injury (isn’t pushing an Olympic event?).

First days:
  • Use frozen pads or apply ice to your perineum (like any injury – ice for the first 48 hours). It sounds uncomfortable now, but will feel great in the moment!
  • Wash your hands before (as well as after) using the toilet until your stitches are healed
  • Pee in the shower/bath if urination causes stinging
  • Use a peri bottle after using the toilet – add herbs/lavender/tea tree oil for their antibiotic and healing properties
  • Take Homeopathic Arnica 30C every 4 hours while awake (minimizes any swelling or bruising)
  • If you feel you need pain relief medication, ibuprofen or acetaminophen can be taken according to the recommendations on the bottle
  • Plan to not go outside for 7 days. Stay in bed and cuddle with your baby, minimizing activity as much as possible. Aim to only walk up/down stairs once or twice a day max.
  • Sit with your legs together, i.e. don’t sit cross legged.
  • Sitz bath twice a day – add herbs/lavender/tea tree oil.
  • Full bath x 10-20 minutes once a day (in addition or instead of sitz bath) – add 2 cups Epsom salts, perineal wash herbs – avoid bubble bath
  • Do NOT sit on a hemorrhoid or “donut” pillow which can cause stitches to tear out
  • Eat healthy, drink lots of water
  • It is normal to feel “heaviness” in your pelvis at the end of the day if you have had increased your activity. This is the pelvic floor muscles getting fatigued. Try to balance days of activity causing fatigue, with days of rest.
  • Prolonged use of maxi pads can be very drying – occasionally try sitting on a blue pad while nursing, or use cloth pads. After a sitz bath, dry out your perineum well, then sit on a blue pad or towel and let your perineum fully dry and breathe for 1-2hours.
  • You will not have the same strength when doing kegels. Be patient, it will return.

Inform your midwife if:

  • You have increasing amounts of pain in your perineum, not associated with increased activity or decreased use of painkillers
  • You have discharge that is abnormal in colour or foul smelling
  • You continue to have serious urinary incontinence past the first few weeks
  • Use lots of lube when you have sex, as postpartum hormones cause dryness.
  • See a pelvic floor physiotherapist if you have any concerns or just want to improve your pelvic floor strength. You do not have to have serious incontinence before seeking physiotherapy. If your problem is assessed to need further medical intervention, they can provide a gynecological referral.
  • BC Women’s Continence Clinic 604-875-3137 (self-referral)
  • Various private physiotherapists specialize in the pelvic floor