Coping with the Pain (Perineum Swelling, Episiotomies, & Tears)

by Melissa D. Jaramillo

Following the vaginal birth of your baby, you are probably in awe of that precious little one. After months of feeling as if you were sporting a monster truck tire on your belly -- that deflated stomach doesn't seem that bad. Tired, maybe even exhausted after the birthing experience, you still feel euphoric.

And then you move.

Among those first trips, (and many subsequent ones), is a journey to the bathroom. In a few years you will refer to this as "going potty", but for now, we'll stick with the adult terms.

Within the first hours, days, and perhaps even weeks following childbirth, you will most likely find this experience to be a bit painful. This is particularly true for those women that had a tear, episiotomy, or stitches for any reason in the perineum region during childbirth. Proper healthcare, hygiene, and pain management don't end with the delivery and are extremely important in hastening your recovery.

Your body has just endured an incredible ordeal. To fathom just how much your vagina distended and the perineum stretched is more information than most people care to dwell upon (Could you imagine if it was the "father" that had to deliver?) Still, as much as that area does allow for, bruising and irritation is common. Many women, especially those experiencing birth for the first time, will have either a tear or end up with an episiotomy. Either of these will result in stitches which do require a little extra care. Women experience pain in varying degrees of intensity and may expect the most intense pain to last from 3-5 days following delivery, up to two weeks afterwards. Minor soreness or irritation may be noticeable later as sexual activities resume but again -- the emphasis is on minor. If you are having intense burning or pain after 2 weeks please contact your care provider immediately. It is most likely a very simple solution but should be attended to. How though to get through those first days and weeks?

Below are some tips that will help provide some relief:

Perineal Cleansing bottle ("peri" bottle): These small, unobtrusive bottles certainly do not appear to be anything special, but rest assured they provide a tremendous amount of relief! Fill with warm water as you enter the bathroom and keep it within reach of the toilet. After urinating and/or elimination, hold the bottle between your legs and squeeze slowly from front to back the area from your vagina to your rectum. The water is cleansing and very soothing. Wait a minute or so and then pat the area dry with clean gauze. Do not wipe, especially if you have stitches.

Mom Testimonial: "I cannot say enough about my little bottle. This may sound silly, but you will know once you use it that having it close by and even a willing partner to fill it again is not only handy -- it works! Be certain that you use it each and every time you use the bathroom!"

Cold Compresses: Focusing in on the fact that you are dealing with swollen muscle tissue in this area, the application of ice packs does not then seem so far fetched. Some women purchase tiny bags of frozen vegetables (peas, corn or mixed are the most frequently recommended.) Others wet and then freeze in secured Ziploc bags their sanitary napkins. Many simply will take small ice cubes in either a plastic bag or paper toweling and secure in place with their sanitary napkins and underwear. Regardless of the method, the object is to reduce swelling. Apply for 15-20 minutes as needed.

Mom Testimonial: "Cold! I hate anything cold -- normally that is! I was so sore and swollen however after the birth of our son that having an ice pack stuffed in my panties suddenly was not a bad idea at all. Granted, I'm certain it was not exactly a turn on for my husband -- but he understood if he ever wanted me to think about sex again, that whatever I needed would be done."

Heat: This option is considered pleasant by many new moms. Steal 5 -10 minutes whenever you can and soak either in a sitz bath of warm water or a few inches of warm water in the bath. Apply warm, wet compresses as you are able. Be certain to gently pat the area dry when you are done to prevent infection by trapped moisture.

Mom Testimonial: "I got to experience a real sitz bath while in the hospital. The nurses were so kind -- even bringing me a scented candle, heating the room prior to my use, and helping me arrange my robe so that I would not become chilled. That 10 minutes was so very comforting. I wanted to go back again and again! My husband decided to try and duplicate it as much as possible in our home tub -- running hot water in first to heat the surface, then filling it with a few inches of nicely, warmed water. Those few minutes were soothing to my stitches (I had a tear during delivery) and rejuvenated my spirit."

Hair Dryer: This advice is probably not listed in the "Product Uses" of your hair appliance -- but many women have learned to appreciate this trick. (There is some debate about blowing dust on open wounds, so if you have stitches you may prefer a different method of pain relief.) After finishing using the bathroom, your peri bottle, sitz bath, etc., train your hair dryer on the area for 2-3 minutes. This is a technique that most definitely is awkward at first but the testimonials on relief would be enough to sell you on trying it yourself. There is some current controversy on whether it could dry out the area too much, but it seems that the experts can agree that using the low heat or cool setting for a period of up to 3 minutes maximum is safe. To accomplish this, stand or even sit on a towel on the floor with your legs apart and knees slightly bent. Hold the dryer approximately 6-8 inches away from your vagina and then turn it on. Do not stay in one area for long but move back and forth, just as you would for drying your hair.

Mom Testimonial: "I would have never thought to expect my hair dryer to be used like this. My gynecologist was female and had experienced birth (along with a painful episiotomy) herself. She used it and highly recommended it. I can now do the same. This was my second birth experience and my healing time from my stitches was much easier this time around. You will feel awkward at first but once that warmth hits that area you won't care!"

Pain Relievers: Be certain to ask your doctor, but most women are able to take Tylenol for pain relief as directed. A tip for breastfeeding mothers -- while Tylenol is considered safe for lactating parents, it is always best to take any medication immediately after nursing to allow it to become less absorbent by your infant.

Mom Testimonial: "If the Tylenol doesn't touch the pain, ask your doctor or caregiver if Motrin is safe for your situation. I found alternating the two those first few days helped me."

Herbal Remedies: Try dabbing the area with Witch Hazel or Calendula. Also recommended are compresses soaked in lavender or chamomile oil to help reduce inflammation. If you are interested in more options or perhaps to learn about aromatherapy, please ask your midwife -- or better yet? Ask Our Midwife!

Mom Testimonial: "My midwife recommended a lotion that I could then apply 2-4 times per day. This was created by combining several essential oils such as Chamomile, Calendula, and other oils. Ask for the directions from your midwife."

Fluid Intake: It was important during pregnancy, but consider it even more so now. Up that fluid intake as much as possible. Think gallon, not quart! Consider this as an incentive -- The more you drink, the more diluted your urine will become. This, in turn, means less acidity, resulting in less burning! Other good choices are sports drinks such as Gatorade. These will help replenish those electrolytes lost in childbirth. The bottom line? Cheers!

Mom Testimonial: "I finally learned to take this advice after my third child. The difference is really worth feeling like you would float your very own Titanic. Seriously, there is much less burning (one of my personal complaints) and I believe it also helped my battle against constipation."

Proper Nutrition: Now more than ever, you want to insure that you have the proper balance of your dietary needs. While it may seem to be overkill, make certain that your fiber intake is higher than normal. Eat plenty of whole grains, salads, or as your granny would say, roughage. You want to avoid becoming constipated at all costs as straining later can cause pulling/stretching of your perineum.

Mom Testimonial: "Ok, I haven't actually followed this advice yet! Following my first birth I was so very eager to eat all my favorite Italian dishes that made me ill during pregnancy. You know the ones. packed to the ceiling with various cheeses? The result was very painful! I became constipated. The pressure of trying to "go" then stretched and pulled my incision. My reality was another embarrassing trip to the doctor and pain that was multiplied tenfold. Next time I will be much more careful about what I eat and drink in those first few weeks!"

Kegel Exercises: "You may be familiar with these exercises in your preparation for delivery. Now that you are post partum, you will find them handy for improving the control you have over your continence levels as well as helping your vaginal walls and floor return to normal as soon as possible. Side benefits? Improved sex life (later when you have the energy!) and it does speed the healing time after birth. Click here for more information on Kegel Exercises.

Mom Testimonial: "Easy to do, anywhere and everywhere! You can even do it discreetly without those around you knowing. Very secret tip: When you resume making love with your partner, try doing a few kegels and watch the fireworks explode!"

Rest: "While the urge may be there to get out and begin exercising right away, please be certain to give yourself time to heal properly before doing so. Even that which is considered normal activities should be returned to at a reasonable rate. Resuming slowly may be frustrating but use this time to allow others the opportunity to help out. You, in the meantime, focus on yourself -- and enjoying that new baby!

Mom Testimonial: "Unbelievably, I was very eager to jump back into my old routine. I had a great delivery and was well on the road to recovery. Fortunately I did listen to the advice of more experienced moms and did allow my body a chance to heal first. Beginning with very simple activities allowed me to recover fully without setbacks later on. Plus -- what new mom doesn't want to be pampered?"

Melissa Jaramillo is mom to many. She's passionate about building, encouraging, and strengthening families on this adventure known as parenthood!

Copyright © Melissa Jaramillo. Permission to republish granted to Pregnancy.org, LLC.