A Guide to Taking Care of the Perineum After Birth

postpartum care for "down there"
A Guide to Taking Care of the Perineum After Birth: newborn baby on mom's chest in birthing pool
© Can Stock Photo / Molka

Perineal healing after baby is the kind of topic that almost no one wants to talk about! However, the majority of women who have recently given birth are seeking advice and guidance on how to help their sensitive bits feel better and recover after the main event. We talk about stretch marks, chapped nipples, engorged breasts, and sleepless nights, but not the zone that has undergone the brunt of the “labour” and delivered our angels earthside. So I’m going to do it, I’m going to go "there"! 

I’m talking about the perineum, the area between your urethra and anus, including your vaginal opening. The strain of a vaginal delivery puts obvious pressure on the perineum, but even women who have had a cesarean section will have also undergone pressure during pregnancy, or in their initial stages of pushing or contractions. Many will naturally tear in varying degrees, and some may have even had an episiotomy — where a doctor will surgically open the perineum.

After my first was delivered by cesarean, I didn’t really even have this topic on my radar. Occasionally moms would come into the birth shop where I work and quietly whisper to me, or dance around the topic. It wasn’t until I gloriously pushed out our daughter at home that this topic really resonated for me. Things went smoothly with the delivery, and I had a much quicker recovery than I could have imagined, but the handful of stitches I had post-delivery were so irritating! My midwife had some great advice, which I will now share with you.

Prepare in advance

There are a few things you can do as you approach your due date to prepare to care for your perineum. “Padsicles” are a popular way to prepare homemade ice packs to help cool your swollen and sore area. Lay a dozen large maxi pads out and spray them down with water or an alcohol-free witch hazel until nice and damp. Wrap them individually in Ziploc bags and toss in your freezer. You’ll be glad to have them on hand for the 24 hours after delivery. Sometimes having these directly on your perineum can be overwhelming, so try a light facecloth in between the pad and your skin.

Purchase a peri bottle to help keep the area clean and lessen any pain when urinating. Most pharmacies will carry peri bottles, but you can use any type of small, squeezable liquid container. The idea is to spray your undercarriage with water (warm is nice) as you urinate to dilute your urine and lessen any discomfort while peeing. Using a peri bottle each time you are in the bathroom can go a long way to keeping your area clean and aid in healing. Make sure you gently pat dry afterwards.

Herbal perineal washes or teas are a very popular holistic way to aid in your perineal recovery. These are brewed in advance and can be applied using your peri bottle, in a sitz bath or in your bathtub. A sitz bath can also be purchased at your local drugstore, or ask for one to take home from the hospital. This can ensure you soak your perineum a few times a day without having to completely undress and get in your bathtub. I personally really enjoyed having 2-3 twenty-minute baths each day for the first week post-delivery. My husband and mother also enjoyed the time with our newborn in their arms while I had this time alone to relax and heal. Some of the ingredients that are popular in perineal washes are: witch hazel, rosemary, lavender, calendula, yarrow, comfrey, goldenseal, myrrh, or aloe vera.

In the weeks to follow

After your baby has arrived, there are some key considerations that will greatly aid in your perineal recovery. In addition to the abovementioned tips, it will be important to get plenty of rest and downtime, and by downtime I mean lying-down time. If you have undergone stitches, it's important to have lots of time with little or no pressure on your perineum. Save the hours of sitting up and visiting for the weeks after your full recovery. Having this downtime will also aid in your efforts to bond with baby and get comfortable with breastfeeding.

Change your pads regularly. Most women will have discharge or bleeding for several weeks post-delivery — another lovely side effect of having a baby that no one talks about. Keeping your perineum clean is critical, so have lots of maternity pads on hand. Tampons are discouraged as they can breed infections.

Your diet

Many women experience constipation after birth. This pressure can really agitate an area that is already dealing with a lot. Ensuring that you are drinking lots of water is critical; this will also help produce lots of healthy breast milk. Along with water, consume lots of high-fibre foods to keep things moving along —  fruits and vegetables are best. Your healthcare professional may recommend a stool softener if things need an extra boost.

Hemorrhoids

Yep, if you didn’t get them during your pregnancy, you just might in delivery! The ice packs and warm baths will go a long way to aid in discomfort, as will the downtime off your derrière. If that’s not cutting it, witch hazel or aloe vera are two natural healers that can help. Ensuring that you are wearing lots of loose-fitting clothing is also important to avoid adding extra pressure to your highly sensitive zone. Still uncomfortable? Your healthcare professional should have some advice on other remedies that will be ok with your personal healing situation.

Last but not least... What about sex?

It may or may not be on the top of your list as you venture into your new role as a mama…or mother of 2… or 3. But chances are you have a partner who is keen to resume relations. Many women take 4-6 weeks to heal from labour and delivery, some more. Your midwife or healthcare provider will be keeping a watch on how things are healing up. Situations with stitches or complications will have specialized aftercare and healing times to consider. Many women experience discomfort the first few times having sex after childbirth — this is normal. Follow your body’s signs and feelings as you navigate the bedroom. Extra time for foreplay (hooray!) can be important as many breastfeeding mamas won't have the level of natural lubricant they are used to (a natural lubricant might be a good investment to keep on hand). If penetration or genital contact just isn’t a green light yet, don’t forget there are lots of other ways that you and your partner can experience intimacy!

Above all, be kind to and gentle with yourself. This is a crazy time of changing hormones, new roles, and responsibilities in your home — a big transition for everyone. Taking the time to rest and recover, focusing on your new babe, and asking for help will speed recovery and make the experience much more enjoyable.

*Originally published October 14, 2016

 

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