Perineal After Care: How to Care for Your Bottom After a Vaginal Birth

Perineal After Care

One of the number one fears of childbirth has to do with perineal tearing or episiotomy (When You’re Scared of Tearing is still one of our most read blogs). 95% of first-time parents will experience some some degree of tearing, but only 4% of those will be the more serious third or fourth degree tear. Regardless, tears can be uncomfortable and you may need to know how to care for your tear.

Immediately after delivery and for the first 24 hours, it can be helpful to apply a cold compress. This can be in the form of an ice pack or a padsicle. To make a padsicle, you will need a large gallon sized freezer Ziploc bag, overnight pads, witch hazel, jojoba oil (or almond or olive oil) and aloe vera gel. Open the overnight pad and add equal parts of witch hazel, oil, and aloe vera to the center of the pad. Close the pad and put it in the Ziploc bag. Continue this until the bag is full. You may want one or two bags full. Put the bags into the freezer until delivery. After delivery, your perineal area will be inflamed and sore (whether you tore or not). Putting the padsicle in your underwear after delivery will help catch the blood and soothe your sore bottom.

When using the bathroom after a vaginal delivery can be tricky. You won’t want to rub toilet paper over the area, as it will be very sore. Most facilities send you home with a peri bottle for this reason. A peri rinse is soothing and helps accelerate the healing process. To make a peri rinse, boil 8 cups of water and pour it over 2 oz of witch hazel root, 2 oz of lavender, 2 oz of calendula, 2 oz of comfrey, 2 oz of oat straw, and ¼ cup of sea salt (if you are allergic to any of these items or are unable to find them, just omit). Place a lid over the solution and let it sit overnight to steep before straining out the herbs. Store this peri rinse in a container in the refrigerator. If you are preparing this in advance, you can freeze it until it is ready to be used. When ready to use, fill the peri bottle ⅓ of the way full of the peri rinse solution and then the rest with hot water. Test that when mixed, the solution is not to hot to be used on sensitive areas. After using the bathroom, spray your entire perineal area with the rinse and carefully pat dry with toilet paper. Use this solution 1-3 times per day while healing.

Another way to promote postpartum healing is by using a sitz bath. To do this, a large basin or bathtub can be used. A sitz bath is commonly used to keep the area clean, promote healing, and ease discomfort. Whatever you are using for your sitz bath, fill it to a level that you could sit in it with warm or cool water up to your hips. You can add Epsom salt if your care provider approves, or do without. The same solution used in your peri rinse can also be added here. Sit in the stiz bath for 15-20 minutes and pat the area dry when you get out.

Hygiene is very important for wound care and infections are a big concern. By keeping the area clean and dry, you can prevent a painful infection that delays the healing process. Make sure to rinse your perineal area every time you urinate or have a bowel movement – remember to be gentle!


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