Healing the Perineum After Birth

Healing the perineum is essential after a vaginal delivery and after a cesarean section. The perineum extends from the vaginal opening to the anus. It is made up of skin, muscles (pelvic floor muscles), and nerves. This area is stretched and thinned prior to labor from the pressure of the baby and the hormone called relaxin. During labor, the skin and muscles in this area thin out, even more, to allow the baby to pass through. Some women may experience tearing or the healthcare provider may use scissors to clip back some of the perineum skin to help the baby’s passage called an episiotomy. These tears or cuts are sewed together with special sutures that naturally dissolve and fall off after several days.

Unfortunately, every time we sit, we can experience perineum discomfort. Healing the perineum quickly is very important for your comfort. Below are a few tips to encourage healing the perineum after birth.

Perineum Healing Tips

1 – Keep the Perineum Clean

This is pretty self-explanatory but especially important for those who experienced a tear during delivery. You shed blood after a vaginal or cesarean delivery, change your sanitary napkins/pads plus spoiled underwear often. Use a peri-bottle with lukewarm water, after using the bathroom, and dab the excess liquid with toilet paper.

Using a sitz bath or a perineum healing spray can help keep the area clean because it traditionally contains herbs that have antiseptic abilities. Allow the area to air dry after use of the spray or a bath. 

2 – Soothing the Perineum

Because this area is very sensitive, there are several things used to help soothe the perineum: sitz bath, perineum balm, perineum rinse/spray, and/or postpartum pads. Typically all these items will contain witch hazel, lavender, and aloe at a minimum. To create your own mixture, you can purchase the herbs online or you can get a premade formulation from Etsy; ensure the ingredients are all organic and the company sources the herbs responsibly.

• Sitz bath is where you submerge your bottom in 3-4 inches of a tea bath. You steep herbs in hot water and allow the tea to cool to a tolerable temperature before you submerge your bottom. There are sitz bath bowls you can purchase online or in a pharmacy store or submerge your bottom in a bathtub with your feet out. Traditionally, you remain in the tea bath for 10-20 minutes 1-3 times daily. 
• Perineum balm uses similar herbs and adds wax to make it into a balm. Using balms with stitches can cause them to pre-maturely dissolve. Make sure you check with your healthcare provider. 
• A Perineum rinse/spray is very similar to the sitz bath, just in a spray bottle. Actually, you can create your own spray or rinse by placing the cooled tea in a bottle and spraying it after using the restroom.
• Postpartum pads not only soothe but collect the bleeding from delivery. Some like to put these pads in the freezer to create pad-icicles. Prepare your postpartum pads or purchase them ahead of time to bring with you to your birthing facility or make sure they are accessible if you deliver at home. 

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3 – No intercourse

Yep, no intercourse. This area is very sensitive and you should wait until your healthcare provider or you are confident that the perineum has healed. When prepared to have intercourse, be cautious and overcommunicate. You do not want to re-injure those tissues. Use lubrication and ensure that you clean the area thoroughly afterward.

4 – Kegel Exercises

Just because the baby is here does not mean you stop those squeezes. Kegel exercises strengthen the perineum muscles after they have been stretched from pregnancy and birth. You should do them several times daily for a few minutes initially and then eventually work down to once daily. A Kegel Exercise smartphone app has reminders and it has a variety of exercises so it did not get boring. 

• find a comfortable position, sitting, lying down, or on all-fours
• Locate your pelvic floor muscles. Act as if you were stopping urine midstream, these are the same muscles you want to contract when doing Kegel exercises
• Tighten the pelvic floor muscles for 10 seconds and relax for as many seconds for sets of 15 to 20; repeat 3 times daily

5 – Comfort

Using a perineal comfort donuts or cushion helps relieve pressure from the perineum. You can purchase a pillow online and some even hold an ice pack which some may find comforting!