How to care for perineal repair

by Kaiser Permanente |
Woman holding a newborn baby and looking at her while seated on a bed.

The perineum — the area between the vagina and rectum — stretches during labor. In many cases, the perineum can tear during birth. The tears are typically minor, but in some cases require stitches to heal properly. In rare cases, clinicians cut the perineum to help deliver the baby. This cut is known as an episiotomy and typically requires stitches to heal.

Caring for the perineum

After you’ve given birth, it’s common for the perineum to be sore. Help make yourself more comfortable by:

  • Applying cold compresses or postpartum cooling pads, witch hazel pads, or Dermoplast spray to help lessen pain and swelling.
  • Rinsing the area with warm water after you use the bathroom. Gently pat the area dry.
  • Sitting in a warm water bath that only covers your hips and buttocks. This is called a sitz bath. You can take a sitz bath several times every day. Avoid using bubble bath products.
  • Using over the counter anti-inflammatory medication like Motrin.

It’s also a good idea to prevent hard stools, which can be painful. Drink plenty of water throughout the day and eat high fiber foods like vegetables, fruits, and whole grains.

If necessary, you can use a stool softener or fiber supplement. You may have been prescribed a stool softener before leaving the hospital, especially if you had an episiotomy. Check with your clinician before starting any medicines or supplements.

Helping an episiotomy or perineal tear heal

If you had an episiotomy or a large tear, you’ll most likely have stitches. They will dissolve on their own, usually within 4 weeks. It can take up to 6 weeks for the area to heal fully.

Help an episiotomy or tear heal by reducing pain and swelling. You can use the same strategies for perineal care listed above. Make sure to rinse the area with warm water after using the restroom and pat dry. No antibiotic creams or ointments are necessary for tears or cuts to heal unless directed by you clinician.

Sanitary pads can be worn, but you shouldn’t use tampons until your clinician says it’s fine.

It’s a good idea to avoid strenuous activities. You can feel free to walk, use the stairs, and perform light household activities. However, until your clinician says it’s okay, don’t ride a bike, jog, lift weights, or perform aerobic exercise. Do not engage in sexual intercourse until you have recovered from the delivery.

When to call your clinician

Call your clinician immediately if you notice signs that you could be bleeding too much, such as:

  • Heavy vaginal bleeding.
  • A fast or irregular heartbeat.
  • Feeling dizzy, lightheaded, very tired, or weak.
  • New or worsening stomach pain.

Infections from perineal tears or cuts are rare. How if you experience any of the following symptoms, please contact your clinician:

  • Fever.
  • Increased pain, swelling, redness, or warmth in the perineal area.
  • New or worsening stomach pain.
  • Pus draining from the cut.
  • Vaginal discharge that smells bad.

This article has been created by a national group of Kaiser Permanente ob-gyns, certified nurse-midwives, pediatricians, lactation consultants and other specialists who came together to provide you with the best pregnancy, birth, postpartum, and newborn information.

Some of the content is used and adapted with permission of The Permanente Medical Group.