If you have had a normal vaginal delivery, then it is very likely that your perineum will end up sore. That is because the pressure from delivery your baby bruises this area. (If you do not know where your perineum is, it is the area between your anus and your vagina.)
Sometimes, there is not enough room to deliver your child and your doctor or midwife may decide that a cut, or episiotomy, in the area is necessary to accommodate your child. This area also sometimes tears on it’s own. Whatever the cause however, it is likely to be quite sore and tender until the bruising or wound heals.
How long these tears and cuts take to heal will vary from mum to mum, but there is a scale to measure the seriousness of the cut or tear. First degree tearing involves the skin only, and usually heals quickly, with minimal discomfort. Second-degree tears are far more common, and they are the more serious type, that requires some stitches. Within two to three weeks, you should have healed from a second-degree tear. Third and fourth degree tearing and lacerations are much more serious, and will take a month or longer to heal, and be much more painful. They are also likely to cause incontinence and cause trouble when you have a bowel movement.
There are several ways to treat and soothe bruising, tearing and cuts on the perineum, and your doctor or nurses will usually advise you of the best method for you. These may include:
Applying a cold compress to the area
Prescription painkillers – but remember to avoid aspirin if you are breastfeeding, as it can be dangerous to your child.
Changing your sanitary towels more frequently
Use the squirt bottle provided by the hospital to squirt warm water on the area when you go to the toilet.
Make sure that you pat or wipe yourself from front to back to avoid infections.
24 hours after delivery, you can start taking hot baths with salt in them.
Witch-hazel, applied with cotton balls or pads can also help to soothe the area.
Try to get as much air on the wound as possible, and doing kegel exercises from soon after the birth can also aid in healing.
If you have a very serious third or fourth degree tear, that involves your anal sphincter, then it is especially important that you avoid constipation. Make sure you eat lots of fibre, drink lots of water, and take a stool softener.
Remember that bending, lifting heavy objects and other work can make your injury worse, so avoid any strenuous exercise, or work for a while.
If you notice that the area around your wound is red, swollen, or inflamed, or if the pain is excessive, or even if you start feeling feverish or sick, speak to your doctor as soon as possible. These are all signs that your wound is infected, and you may need antibiotics to clear up the infection.
Avoid sex until at least your six-week check up. Particularly bad tears and cuts may take even longer though, and you may have to wait until your doctor gives you the go ahead before you start having sex again.