How to take care of the perineum after childbirth

First days after childbirth

The first few days after the baby is born are the hardest, especially if you have a vaginal tear or an episiotomy .

To deal with them in the best possible way, it is important to receive the support of a competent midwife already at the birth point , who teaches the new mother how to manage postpartum losses (called lochias ), take care of intimate hygiene , relieve the pain of any wounds and prevent possible infections .

In case of natural birth and in the absence of particular problems, the most frequent advice is to apply ice or wash with cold water to reduce swelling .

To avoid pressure on the perineal area in a sitting position, a donut cushion could also be useful , to be applied under the pelvis. 

In addition, in case of intense pain , the gynecologist may prescribe the use of painkillers compatible with breastfeeding .

Postpartum hygiene

Especially in the case of lacerations or episiotomy, it is essential to carefully take care of intimate hygiene , following the instructions received from health professionals at the birth point.

After urinating, it is advisable to rinse the private parts with fresh water , to relieve pain and burning . 

Furthermore, to accelerate the healing of wounds, it is possible to use a solution of water and calendula mother tincture , which has a high disinfectant and healing power .

Postpartum cleanser: which one to use?

After the first few days, you can start using a delicate postpartum intimate cleanser that respects the physiological pH of the mucous membranes .

In case of inflammation, it may be useful to use an intimate soap based on sage and thyme , excellent antiseptics that respect the vaginal and vulvar flora .

Postpartum perineal exercises

If the gynecologist gives the green light and the mother feels like it , it is possible to perform perineal gymnastics even a few days after giving birth.

Resuming the Kegel pelvic floor exercises done during pregnancy (or starting them if you haven’t done them before) will help reabsorb swelling , reactivate circulation and restore muscle tone .

All this, in addition to speeding up recovery, will help resolve some possible ailments, such as postpartum incontinence , and facilitate the resumption of sexual intercourse (which generally requires an abstention period of around 40 days after giving birth). 

In this regard, it is important to underline that all women, after pregnancy, should be offered a postpartum recovery path , preferably with a midwife specialized in re-education and rehabilitation of the pelvic floor .

The evaluation of the perineum by a professional, in fact, allows to establish the actual state of the muscles of the new mother and to propose targeted exercises .

Postpartum perineal massage

Unlike pelvic floor exercises, postpartum perineal massage should only be started after the postpartum gynecological examination , which is usually 6 weeks after the birth of the baby.

This practice, in fact, must be carried out only after the complete healing of any lacerations or episiotomies and in the absence of vaginal infections .

The massage technique is no different from that adopted in the last weeks of pregnancy. However, in case of scars , it is useful to insist on these areas to soften them , starting with an external massage.

The fingers, well lubricated, must slide along the line of the wound , then move perpendicularly and finally perform circular massages , always proceeding from the vagina towards the anus . Subsequently, you can proceed with the internal perineal massage , always insisting on the level of the scar. 

Postpartum perineal massage: which products to use?

The massage should be performed with an oil or lubricant that respects the vaginal mucosa .

On the market, there are several specific products for perineum massage ; alternatively, you can use St. John’s wort oil or an aliamide-based gel .

As always, in any case, to choose the most suitable lubricant for individual needs, it is advisable to ask your gynecologist or trusted midwife for advice .