The perineum is the area between your vagina and rectum. It stretches during labor and vaginal birth, but sometimes it can’t stretch enough and it may tear. Tearing is common in childbirth, especially if you are delivering a baby over 8 ½ pounds or if forceps are used to help deliver him. If your baby is being delivered face up, there is more of a chance of tearing. You may be more likely to tear if this is your first labor and birth, or if you had tearing or an episiotomy (a cut made at the opening of the vagina to help widen the passage) in a previous birth.
Tearing may affect only the tissue around the vagina which should heal on its own, or the muscles between the vagina and anus may be torn which would require stitches by your provider post delivery. In more rare and severe cases, rectal tissue may be torn requiring the surgical skill of a specialist.
The perineum often is pretty sore after giving birth and it can take a couple of weeks before you’re comfortable enough to sit on a hard chair again. This is especially true if you have stitches from a tear or an episiotomy. While healing, it is important to keep the area clean. Rinse with warm water after every time you use the toilet and always wipe from front to back to help prevent infection.
Here are some things you can do to help you feel more comfortable and heal sooner:
• Kegel exercises – These strengthen the muscles in the pelvic area, which helps the perineum heal. They’re easy to do – just squeeze the muscles you use to stop yourself from peeing. Hold the muscles tight for ten seconds, then release. You can do this anytime, anywhere (in the car, at the grocery store, in an elevator…) so do them whenever you think about it.
• Put a cold pack on your perineum – just be sure to wrap it in a towel so you don’t freeze any skin!
• Sit on a pillow. Some gals highly recommend a donut shaped pillow.
• Soak in a warm bath.
• Use stool softeners to keep from getting constipated.
If you try all this and you’re still really uncomfortable, ask your health care provider about pain medication for a few days. You can read more and watch a video about postpartum discomforts at this link.