How to deal with Perineal Pain after Childbirth

Postpartum Perineal Pain – Cause and Relief

Medically Reviewed By
Dr. Rima Sonpal (Gynecologist/Obstetrician)
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You might think that labour and delivery are the most painful part of childbirth. But you may experience considerable pain even after the birthing experience. A baby can weigh around 6 to 8 pounds (2.5 – 3.5kgs) and it might be difficult to pass it through a narrow opening, leading to vaginal tears or some form of discomfort in the perineal area.

What is Postpartum Perineal Pain?

The perineum lies between the vagina and the anus, and it undergoes a lot of stretching and immense pressure during delivery. The intensity of pain, coupled with the recovery time, varies on the method of delivery. If you had a vaginal birth without any tears (episiotomy), discomfort in your perineal region might last for about 3-5 weeks. The pain could last for as long as 6 weeks if you went through an episiotomy. Some perineal discomfort may be felt even after a C-section delivery, depending on how long you pushed.

To relieve vaginal pain after birth, you can resort to the following measures.

  • Ensure the area is clean: You can spray warm water with the help of a squirt bottle over the painful area.
  • Apply a cold pack: Crushed ice with an inbuilt cold pack can be applied on the area to reduce the amount of swelling. It should be applied for a couple of hours, after 24 hours of the delivery.

Why Does The Perineum Become So Sore After Delivery?

In a vaginal birth, compression on the perineum is immense because it needs to be stretched for the head of the baby to be accommodated. During the process of birth, the perineum is prone to wear or tear, or your doctor may suggest an incision, creating a wider opening for your baby’s head. This procedure is termed as an episiotomy, and you will encounter immense soreness after birth if you are required to go through one.

As discussed earlier, if the birth is accomplished without a tear or episiotomy, chances are there that the perineum could be tender or swollen afterwards. It may heal in a week, or it could take a couple of more days to get back to normal. The healing period is longer if you went through an episiotomy.

Why Does The Perineum Become So Sore After Delivery?

How Long Does it Take to Heal Perineal Pain?

The process of healing varies from one woman to another. The deeper the cut, the longer the recovery procedure is expected to be. A tear of the first-degree means more skin is involved than muscles, and you may not even need stitches. First-degree tears are known to cause a minimum amount of discomfort, as they tend to heal quickly.

When it is a second-degree tear, then both muscle and skin are involved. This requires stitches and would need a couple of weeks to heal. During this time, the stitches dry out, and some women experience pain for a few days, whereas for others it may stretch to months as well.

If it’s a third or fourth-degree laceration, deeper sutures are required, and the pain could stretch to more than a month. Any individual could experience these tears, but chances will increase if you have had an episiotomy. After a few days of birth, you are likely to experience difficulty in bowel movements or urinating. There could be chances of an increase in passing motion and gas, which could prevail for several months.

How to Deal With Pain and Heal the Area?

  • Your doctor or healthcare service provider is going to provide you with detailed inputs on how to take care of yourself. The onus of treatment mechanisms is centred around postpartum perineal pain relief.
  • Immediately after the birth of the baby, an ice pack needs to be applied with a smooth covering over the perineum. That is a primary requirement, and your nurse will provide you with one. This is going to reduce the discomfort along with swelling. Over a period of the next 12 days, apply a single ice pack each day.
  • Acetaminophen or Ibuprofen can reduce pain. If you are breastfeeding, it is better to avoid aspirin. When you experience an unexpected tear, a pain medication prescription may be advocated.
  • Change the sanitary pad frequently during the day.
  • Do not sit for long hours at a single place as the perineum may be sore.
  • A squirt bottle is generally provided by your hospital, whereby you can spray warm-hot water on your perineum. This water has a soothing impact, and it does not burn much once contact is established with your skin.
  • The wound should be exposed to air as much as possible.
  • You can plan for warm soaks in the bathtub or a sit-in bath. You can even add potassium permanganate to the bath once 24 hours have passed since delivery. In this form of a bath, a shallow basin is filled with hot water and put over your toilet seat. The utility of it is that you can soak your perineal area several times a day without having to get into a tub full of water and undress each time. Most hospitals have this form of bath in their repertoire, and if you desire, you can take it home as well. It is also available at most drug stores.
  • Try to take things easy and do not indulge in unnecessary chores. All your energy should be directed on taking care of the baby and speeding up your recovery.
  • If the tear happens to be of higher magnitude, ensure that your fluid intake is on the higher side and enough roughage is part of your diet so that you do not suffer from constipation.
  • Avoid any rectal treatments along with enemas (fluid injected for bowel cleansing or to relieve constipation).
  • If you feel that the pain is not reducing within a few weeks, it is better to seek professional help.

When to Seek a Doctor’s Help

Perineal pain after delivery is an inevitable part of the childbirth process, and as your hormone levels will be fluctuating, you might feel highly emotional during this time. An emotional counsellor would be of immense help now. As a golden rule, if you feel that things are not on the right track as far as you and the baby are concerned, immediately seek the expert advice of a doctor.

When to Seek a Doctor’s Help

Seek the doctor’s help if you encounter the following symptoms:

  • Any form of vaginal discharge with a strong odour.
  • Dizziness or fainting.
  • Difficulty in urinating or pain during the process.
  • Vomiting at regular intervals.
  • Breasts become sore and are too soft or red to touch.
  • Any form of pain in your legs with swelling or redness.

Your doctor is the right person to figure out the underlying causes of the above-mentioned symptoms. It is possible that you could have an infection.

Childbirth can be a painful process. There might be chances of developing anal fissures and haemorrhoids while pushing the baby out. This can be highly uncomfortable and at times extremely painful. But with good care, hygiene and time, perineal pain can heal quickly.

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