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You've just had a baby and you remember very little being discussed in prenatal classes about vaginal or perineal care. The discharge nurse on the postpartum unit went over how to keep your perineum clean and sent you home with a bottle to spray warm water "down there", but let's face it, you were focused on your baby, not her instructions.
Postpartum pain and discomfort are not something that you can dismiss after a vaginal delivery. Even those women who've had a Cesarean section have bleeding and other discharge from the vagina. All of you going through the birth experience will have your first postpartum period soon, with pelvic pain and menstrual cramps. So, postpartum care of the perineum doesn't end when your pregnancy does. It has just become the treatment for your postpartum symptoms.
What Are the Possible Causes of Postpartum Vaginal Pain and Discomfort?
Let’s face it, childbirth can be pretty rough on perineum and vaginal tissues. The healing process may take up to six weeks after delivery. Postpartum symptoms associated with your perineum can include vaginal bleeding, severe pain, swollen skin, and even a white vaginal discharge called lochia.
If you’ve had a vaginal birth, the vaginal opening has just been stretched to it's limits to pop a very large wriggling object out of the uterus. This stretching of the pelvic muscles and tissues causes pain, soreness, and swelling, as well as a considerable increase in blood flow during delivery, not to mention the hormone changes your entire body has undergone. As your body heals, the symptoms will settle down, allowing all the excess tissue and stinging sensation from birth to ease. Giving birth was no easy task, and postpartum recovery is also not a walk in the park!
Episiotomy and Perineal Tears
You may also have had an episiotomy (an incision between the vagina and the anus) before delivery. The obstetrician does this to create more room for the baby to pass through and relieve pressure on the baby’s body. Sometimes the mother’s perineum will tear even with an episiotomy. The surgeon will usually repair the cuts or perineal tears within an hour after your baby is born. Stitches will be sutured in and are usually the kind that dissolve naturally. Postnatal bleeding from the cuts may happen because of the increased blood flow to this area.
You may need to avoid certain activities for the next few weeks while the cuts are healing. Your obstetrician or midwife will discuss these instructions with you.
Vaginal Dryness
Postpartum dry skin in the vaginal area is normal. Women who’ve decided to breastfeed their baby may experience this more often. Nursing moms are likely to have lower estrogen levels than those who are not. These hormonal changes cause vaginal dryness. This dryness may improve within three to six months after giving birth, as estrogen returns to its normal level.
Vaginal Bleeding
Postpartum bleeding happens with most every delivery, whether vaginal or by Caesarean section, and even if you didn’t have an episiotomy. This bleeding is initially more red and may later become lighter in color and less intense in flow. This discharge is called lochia and may sometimes appear as a thick white discharge, much like cottage cheese. It has an unusual smell and can sometimes be mistaken for yeast in the vaginal area.
Lochia is a mixture of white blood cells, tissue, blood, and mucus. Those moms who are breastfeeding may see it and experience the symptoms before others and feel it more intensely. Breastfeeding or pumping breast milk stimulates the uterus to contract forcefully. The body does this to replace the inner lining of the uterus more quickly after delivery.
Using the Toilet
The simple act of peeing or moving your bowels can be painful at the beginning of the postpartum period. There has been a lot of trauma in that area, and evacuating water and stool will not be as easy as before birth. Many women will experience urinary incontinence during pregnancy, and this may continue after delivery.
Pain with urination and straining to have a bowel movement are common symptoms due to the position of these organs to the vagina. Some pain relievers can cause constipation, so begin weaning yourself from any prescription pain medicine as soon as the physician gives you the okay.
Keeping the cuts or tears to the perineum clean is crucial, so new moms need to protect the vaginal area. Next, we’ll discuss tips for the care of the perineum.
Perineal Care Tips After Childbirth
Preventing infection of the perineum is essential. Here are some tips for postpartum perineal care:
- After using the toilet, pour warm water into a sitz bath and use it to rinse off the perineal area. Or, you can pour warmed water into a squirt bottle or a specialized peri bottle to ease discomfort and cleanse the area. This treatment can help reduce irritation and relieve sore, uncomfortable tissues in the vagina.
- While the perineum is healing, women experience symptoms of irritation, pain, and itching of the skin “down there,” the pain of the incisions, and the discomfort caused by their uterine contractions. A sitz bath and rinsing with water using a squirt bottle provide pain relief and ease itching in the first few weeks after giving birth. Be sure to pat dry to prevent irritation from wetness.
- After using the bathroom, wipe from front to back gently. This action will keep the bacteria from your anus from infecting the cuts or tears around the vaginal area.
- While you are relieving your bowels, you may want to use a clean maternity pad to place on the cut to help relieve pressure as you gently bear down. If constipation is an issue, ask your doctor about using a stool softener or laxative to soften your stools.
- If you wear underwear and sanitary pads, your doctor may recommend that you remove these and lie on your bed for 10 minutes or so to get fresh air to your perineum.
- When washing the perineum, use non-irritating soap and refrain from using harsh detergents when washing your clothes.
- Staying hydrated to help relieve dry skin from the inside by drinking lots of water.
- Take short walks to stretch your legs and see if the fresh air will help distract you from the soreness.
- An herbal remedy you may want to discuss with your physician is using witch hazel pads for postpartum itchy skin. This remedy has cleansing and healing properties, and can help reduce vaginal pain and the risk of infection if used properly. Instead of toilet paper, use pads infused with this herbal liquid to wipe.
After a few weeks, the incisions or cuts should be healed, reducing the risk of infection. Discuss the healing process of postpartum recovery with your OB/GYN.
How to Manage Vaginal Swelling and Pain After Giving Birth
According to the Mayo Clinic, women can treat vaginal swelling and pain using some of the following techniques:
- Sit on a padded ring or pillow to relieve soreness of the perineal area and postpartum pain.
- Use an ice pack to cool the perineal area. One source mentions that nurses on the postpartum floor brought baby diapers filled with ice for this purpose.
- Place a frozen or chilled pad soaked in witch hazel between the perineum and a sanitary pad to soothe this area.
- Talk with your doctor about using an over-the-counter pain reliever or anti-inflammatory medicine for pain and swelling.
Vaginal Changes After Giving Birth: What to Expect
A vaginal delivery can hurt your pelvic floor muscles and stretch them out of shape. Because these muscles support your uterus, bladder, and rectum, women can experience leaking of urine, called incontinence.
Try some Kegel pelvic floor exercises to help get these muscles back in shape. To do this, squeeze the vaginal area, holding it for 3-5 seconds, then relax for five seconds. Do 10-15 repetitions in a row and do three sets per day.
Bleeding can occur for a few weeks and sometimes be intense if you are breastfeeding. It is the body’s response to the stimulation provided by breastfeeding or pumping breast milk. Nursing mothers may find that their bleeding is more than that of those not nursing, as the body expels the uterine lining, preparing it for a new one.
Hemorrhoids are another issue common in pregnancy and in postpartum women. These are swollen veins in the anus that occur when you’ve strained. These engorged blood vessels could be caused by pushing in a vaginal birth or when having a painful, solid bowel movement.
You may tend to be afraid of having a bowel movement due to painful hemorrhoids or the risk of opening the vaginal cuts once again. The doctor can recommend a stool softener to help keep your stools soft and regular and prevent constipation. Additionally, you can eat foods high in fiber and whole grains, and drink plenty of water to loosen up your bowels.
When to Seek Medical Help for Postpartum Vaginal Issues
Let's discuss some of the reasons you need to seek help from a medical professional for postpartum care.
- Heavy bleeding - if you are passing enough blood to soak through more than one maxi pad per hour, or passing large blood clots consistently. Postpartum bleeding should be just like having a heavy period, but not more.
- Foul-smelling discharge - if the lochia is pungent-smelling or you have a fever, this is a sign of infection, and you should seek medical help immediately.
- Vaginal pain or long-lasting soreness - if you are having pain for more than six weeks, discuss this with your doctor. Make sure to tell them of any pain medications you've taken to relieve pain and swelling.
- Vaginal pain with sex after healing of the vagina - if pain during sex continues months after having your new baby, speak with your gynocologist about this. There are treatments they can recommend to make sex pleasurable again.
Tools and Tips to Enhance Your Postpartum Recovery
Momcozy has you covered!
This postpartum recovery period doesn’t have to be so tough. Momcozy has the tools to make this stage in your life a little smoother and much more comfortable!
The Momcozy Ergowrap Postpartum Belly Band is an essential tool for new moms who’ve recently given birth. It offers lower back support and helps you maintain proper posture. This hospital-grade postpartum belly band helps maintain proper uterine positioning, stabilizes organ positioning, aids in restoring abdominal tone, and improves overall appearance. For those new moms who have just had a C-section, the Ergowrap offers abdominal support by gently applying pressure and stabilizing the wound area. Due to its soft, breathable, and skin-friendly fabric, Momcozy stands out by preventing friction and irritation. The Ergowrap has been designed to protect the incision while promoting a smoother and more comfortable recovery.
The Momcozy Bamboo Pregnancy Postpartum Panties feature a uniquely designed V-shaped 145° low waist that provides maximum comfort and a flawless fit, preventing rolling or folding. During pregnancy, their low profile will help you maintain comfort, and postpartum, they will maintain their elasticity if you have weight loss. They offer support without compression that is gentle on any C-section scarring and a woman’s sensitive skin during pregnancy and their postpartum period. The underwear features a widened back waistband, offering exceptional softness and stretch. Whether you've had a vaginal delivery or C-section, you'll appreciate the comfiness of these panties.
Momcozy’s Compression Socks offer proper compression without causing pain. The socks enhance circulation, reduce swelling, and relieve leg fatigue. They’ll keep your legs energized and comfortable. The compression socks won’t slip down, and they feature a “sticky” design on the bottom to ensure your safety from sliding. Momcozy's compression socks are crafted from soft, skin-friendly materials that resist pilling, shrinking, and fading, while maintaining their compression levels even after multiple washes.
Concluding Thoughts
This postpartum period is a time for focusing on bonding with your baby and caring for them. The sore tissues, vaginal irritation, and all the pain associated with a perineal tear or episiotomy do not make the postpartum experience pleasant. Knowing and anticipating the postpartum care that you may face after the birth of your baby helps you better cope with it. Caring for yourself is essential, and we hope these tips for postpartum recovery will help you manage it effectively and promote your overall well-being.
