Paracetamol is often prescribed for breastfeeding mothers who require pain medication after an episiotomy. [4] X Research source
Make sure that you do not leave the ice pack on for more than 15 minutes at a time. Take it off now and then to prevent your skin from getting too cold.
You may also find that sitting on a pillow or inflated ring will reduce the pressure and pain in your perineum.
Fill a bathtub with warm or cool water. Warm water increases the circulation and may feel good, but cool water can decrease the pain a bit faster. Sit in the bath for up to 20 minutes.
To reduce discomfort and keep your stitches clean, pour water over the area using a squeeze bottle or water bottle as you are urinating. After you have finished going to the bathroom, squeeze a little more water over the area to clean it off. [8] X Trustworthy Source Mayo Clinic Educational website from one of the world’s leading hospitals Go to source
Make sure that you discard the pad after you have finished and use a new one every time you have to go.
Drink at least eight 8-ounce glasses of water a day if you are bottle feeding and a few extra if you are breastfeeding. [10] X Research source Try not to get compulsive about drinking water because over hydrating can cut your milk supply. Just don’t allow yourself to be thirsty during the day. Eat foods that are fiber rich. Fiber rich foods will help loosen your stool and make it easier to have a bowel movement. [11] X Research source Fruits and vegetables are good sources of fiber. Get some mild exercise like walking during the day. [12] X Research source Exercise helps your colon move food along. Aim for 15 to 30 minutes of mild exercise a day in the postpartum period. Talk to your doctor if you still experience constipation. Call your doctor if these measures do not make a difference in your bowel habits within a couple of days. Your doctor may recommend a gentle stool softener until your body becomes regular again. [13] X Research source Do not take an over-the-counter stool softener without consulting your physician.
Always rinse the area with water after urinating and wipe your bottom from front to back after you have a bowel movement. Doing so will help keep the area clean and reduce the potential for infection from bacteria in the stool.
Kegel exercises strengthen the pelvic floor muscles that support the bladder, uterus, and rectum. In addition to helping your episiotomy wound to heal, these exercise can also help reduce urinary incontinence in women and strengthen contractions during orgasm. [14] X Research source To perform Kegel exercises, start with an empty bladder and imagine trying to stop yourself from urinating and passing gas at the same time. You are trying to squeeze and lift the area. Be sure that you are squeezing and lifting without using any other muscles. Do not tighten your stomach muscles, squeeze your legs together, tighten your buttocks, or hold your breath. Only the pelvic floor muscles should be working. [15] X Research source
When you are napping during the day or at night, take off your underwear so that your wound will get some exposure to the air.
Make sure that you change your sanitary pad ever two to four hours even if it looks clean.
Ask your doctor before you start resuming sexual activity to make sure that it will be safe for you to do so.
Increasing pain The wound appears to break open You have discharge with a bad odor You have a hard or painful lump in the area[20] X Research source The skin between your vagina and anus looks redder than usual The skin between your vagina and anus looks swollen You see pus coming from the stitches[21] X Research source
Your baby is large and needs more room to exit your body Your baby’s shoulders get stuck during the delivery Your labor is so fast that the perineum doesn’t have time to stretch before the baby is ready to come out Your baby’s heart rate indicates that the baby is in trouble and needs to be delivered as fast as possible. Your baby is in an abnormal position[23] X Trustworthy Source Mayo Clinic Educational website from one of the world’s leading hospitals Go to source
A midline or median incision is made from the end of the vagina back toward the anus. These are the easiest for the surgeon to repair after the baby’s birth, but they also have the highest risk of extending or tearing back to the anus during the birth. A mediolateral incision is done at an angle from the back of the vaginal opening and away from the anus. This offers the best protection against tearing to the anus but is more painful for the woman after delivery. This type of incision is also more difficult for the surgeon to repair after the birth of the child.
Make sure that your wishes are noted in the birth plan that the hospital staff will follow during the delivery. You will either develop this plan in your doctor’s office or during pre-admission. During labor use a warm compress against the perineum to help the tissue to more easily stretch during delivery. Ask your doctor if you can stand or squat to push. This places more pressure against the perineum, helping it to stretch. Push for five to seven seconds gently while breathing through it in the initial stages of pushing which slows the delivery of the baby and gives the head more time to place pressure on the perineum and allow it to stretch. Have your practitioner place gentle counter-pressure on the perineum during delivery so it doesn’t tear.
Set aside 5–10 minutes every day to perform Kegel exercises.
Lie on your back with your head against some pillows and your knees bent. Massage a small amount of oil into the skin of the perineum. You can use a vegetable based oil or coconut oil to help soften the tissue and to help make it stretch. Place your fingers around two inches inside your vagina and press downward toward the anus. Move your finger in a u-shape, stretching the skin between the vagina and anus. You may feel a tingling or burning sensation. Hold this stretch for 30 to 60 seconds and then release. Do this stretch two to three times every time you do a perineal massage.
