Perineal Tear: What to Expect at Home

Your Recovery

A perineal tear can happen when you deliver your baby. It is a tear to your perineum (say "pair-uh-NEE-um"), which is the area between your vagina and anus.

After delivery, the doctor or midwife usually closes the perineal tear with stitches. The stitches will dissolve in 1 to 2 weeks, so they will not need to be removed. You may notice pieces of the stitches on your sanitary pad or on the toilet paper when you go to the bathroom. This is normal.

Sometimes, a small tear won't be closed with stitches and will be allowed to heal on its own.

Recovery can be uncomfortable or painful, depending on how deep and long the tear is. It's most painful at the beginning, but you should feel better each day. Pain typically affects sitting, walking, urinating, and bowel movements for at least a week. Your first bowel movement may be painful. A tear is usually healed in about 4 to 6 weeks.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself?

Taking care of your body

• Use pads instead of tampons for bleeding. After birth, you will have bloody vaginal discharge. You may also pass some blood clots that shouldn't be bigger than an egg. Over the next 6 weeks or so, your bleeding should decrease a little every day and slowly change to a pinkish and then whitish discharge.
• For mild pain, try an over-the-counter pain medicine, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). Read and follow all instructions on the label.
• If your doctor or midwife gave you a prescription medicine for pain, take it as prescribed.
• Ease constipation by drinking plenty of fluids and eating high-fiber foods. Ask your doctor or midwife about over-the-counter stool softeners.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Avoid lifting anything heavy or doing strenuous activities, such as bicycle riding, jogging, and weightlifting, until your doctor or midwife says it is okay.
• You may shower and take baths as usual. Pat the incision dry when you are done.
• Ask your doctor or midwife when it is okay for you to have sex.

Wound care

• Put ice or a cold pack on the sore area for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.
• Sit in a few inches of warm water (sitz bath) for 15 to 20 minutes 3 times a day and after bowel movements. Then pat the area dry. Do this as long as you have pain. You may find that it feels better if you dry the area with a hair dryer instead of using a towel to pat the area dry.
• Keep the area clean by pouring or spraying warm water over the area outside your vagina and anus after you use the toilet. Use baby wipes or medicated pads, such as Tucks, instead of toilet paper after a bowel movement.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Share this information with your partner, family, or a friend. They can help you watch for warning signs.

Call anytime you think you may need emergency care. For example, call if:

• You passed out (lost consciousness).

Watch closely for changes in your health, and be sure to contact your doctor if:

• You have signs of hemorrhage (too much bleeding), such as:
  • Heavy vaginal bleeding. This means that you are soaking through one or more pads in an hour. Or you pass blood clots bigger than an egg.
  • Feeling dizzy or lightheaded, or you feel like you may faint.
  • Feeling so tired or weak that you cannot do your usual activities.
  • A fast or irregular heartbeat.
  • New or worse belly pain.
• You have symptoms of infection, such as:
  • Increased pain, swelling, warmth, or redness.
  • Red streaks leading from the wound.
  • Pus draining from the wound.
  • A fever.
  • Vaginal discharge that smells bad.
  • New or worse belly pain.

Watch closely for changes in your health, and be sure to contact your doctor if:

• Your vaginal bleeding isn't decreasing.