Postpartum Perineal Care
WHAT YOU SHOULD KNOW:
- Postpartum perineal care is cleaning and caring for your perineum after having a baby. The perineum is the area between the vagina (birth canal) and the anus (rear end opening). In the first few weeks after childbirth, you will probably have soreness or pain in your perineum. You will also have discharge coming out of your vagina.
- You may have also had a tear or an episiotomy during childbirth. An episiotomy is an incision (cut) that caregivers may make between the vagina and the anus to prevent tearing during delivery. The incision is sewn back together right after your baby's birth. Perineal care will help your perineum heal faster, feel better, and help prevent infection. Ask your caregiver how long you should keep doing perineal care. You may need to continue doing perineal care for 1 to 3 weeks after giving birth.
- Keep a current list of your medicines: Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.
- Take your medicine as directed: Call your primary healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine.
- Medicines such as acetaminophen or ibuprofen may help to decrease your perineal pain. If you are taking medicine that makes you drowsy, do not drive or use heavy equipment.
- If you had an episiotomy or a tear, your caregiver may also suggest that you take a stool softener. A stool softener is a medicine that helps to soften your bowel movements. Stool softeners may help to decrease pain caused by straining during a bowel movement.
Ask for information about where and when to go for follow-up visits:
For continuing care, treatments, or home services, ask for more information.
What should I know about vaginal discharge after childbirth?
You will have a vaginal discharge called "lochia" after delivery. Wear perineal pads (peri-pads) in your underwear to absorb the blood and discharge from your vagina. Change your pads often to keep from getting an infection.
- For the first 3 to 4 days after you have had your baby, blood flow will be heavy and dark red. Some women pass a few small clots and blood.
- From the 4th to the 10th day, the amount of discharge slows down and becomes pink or brown. After that, you will have a creamy or yellowish discharge for another 1 or 2 weeks. This creamy colored discharge may continue for a longer period of time if you are breast feeding.
How do I clean my perineum?
Rinse your perineum with water after you use the toilet and before you put on a new peri-pad. Caregivers will show you how to use a peri-bottle (hand-held squirt bottle) to rinse your perineum. Squirting warm tap water on your perineum will keep it clean and may provide comfort for pain.
- Wash your hands before doing perineal care.
- Remove the soiled peri-pad starting at the front (vaginal area) to the back (anus).
- While you are sitting on the toilet, rinse your perineum. Aim the bottle opening at your perineum and spray so the water moves from front to back.
- Pat the area dry with toilet paper or cotton wipes starting at the front and moving to the back.
- Put on a fresh peri-pad. Apply the peri-pad from front to back by placing the front part of the peri-pad against the perineum first. Do not touch the inner surface of the peri-pad.
- Wash your hands after doing perineal care.
What can I do to decrease perineal pain?
The following are some things that you can do to decrease pain in your perineum. Caregivers may tell you about other ways to make your perineum feel better as it heals.
- Sitz baths may provide comfort, decrease pain, and help to heal your perineal area. To take a sitz bath, fill the bathtub with about four to six inches of warm water. You may also use a portable sitz bath instead of drawing water in the bath. Sit for 20 minutes two to three times a day. Do not use a sitz bath to bathe. Put on a fresh peri-pad after the bath.
- Using an ice pack may decrease your pain. Fill a plastic bag with crushed ice. Wrap the ice pack in a wash cloth. Gently place the ice bag between your legs for 15 to 20 minutes. Remove the ice pack for at least 10 minutes before placing it between your legs again.
- Caregivers may also give you a medicine spray or wipes soaked with numbing medicine to decrease the pain. Use medicine sprays after perineal care or a sitz bath. Compresses or pads that contain an herb called witch hazel may also help to reduce pain.
- To reduce pain while sitting, tighten the muscles of your buttocks before sitting down.
CONTACT A CAREGIVER IF:
- The discharge coming out of your vagina:
- Gets heavier (soaking one pad every 1 to 2 hours).
- Turns bright red after having turned pink, brown, or cream colored.
- Starts to smell bad.
- Has large blood clots.
SEEK CARE IMMEDIATELY IF:
- You feel weak or light-headed and have larger amounts of bright red bloody discharge.
- You have abdominal pain or vomiting (throwing up), and a fever (high body temperature).