Perineum Massage and Healing After Birth

The perineum is the area of tissue between the anus and the vagina. During labor and especially the second stage, all the pushing and pressure from the baby’s head causes reduced blood flow and therefore swelling to the perineum. This swelling in the perineum causes discomfort for the first few weeks after birth. Now that your baby has been delivered, you will need to care for the perineum with massage, especially if you have had stitches, in order to help in the healing process.

Here are some helpful hints to help with this healing process:

• Avoid touching the perineum area.
• Apply ice packs every couple of hours for the first 12 to 24 hours. This will help to reduce swelling
• During urination, use a peri bottle or perineal squirt bottle to direct warm water on to the perineum so that the urine is diluted and won’t sting. Use it after a bowel movement too for added cleanliness.
• Don’t strain when having a bowel movement and support the perineum when you are having a bowel movement.
• After urination, pat the area dry from front to back (this prevents germs from the rectum entering the vaginal area).
• Change your sanitary pad very regularly.
• If you can get some peace and privacy, lie on your bed minus the sanitary pad to let the area "dry out in the fresh air".
• After the first day, heat helps to increase circulation to the perineum and aids the healing process. You can use a heat lamp, a blow dryer or a warm sitz bath. A sitz bath can be a normal bath with salt added or you can sit in a bowl of very warm water with salt added for 20 minutes. An old remedy for a soak is to mix equal parts uva ursi, shepherd’s purse and calendula (available from a herb supplier) in a large jug. Fill the jug with boiling water, seal it and let it stand for 8 hours at room temperature. Strain the herbs from the liquid and add the tea to the bath water.
• Daily Kegel exercises increase the circulation to the perineum helping to reduce swelling and promote healing. Tighten the vaginal muscle (as if you are trying to stop urinating) and hold for 20 counts for 20 times per day. You can do these exercises in groups of 5, 4 times per day.
• Always avoid standing or sitting for long periods during the healing process (the first 6 weeks after delivery).
• Try to relax and give yourself time to heal. You have a new baby to care for but you also need to make sure you are caring for yourself too.
• If you are experiencing pain or a fever, consult your midwife or doctor. Fever can be a sign of infection (which is always possible when stitches or cuts are involved though the risk is small).

With time and care, the few weeks of discomfort will quickly pass and by the time you go for your 6 weeks checkup, your perineum will be completely healed.