This is truly the one blog post that I wish there was no need for, but if you arrived here it’s because it happened and you are now looking for ways to heal. So I’ve written this for you. (If you are just one of those gals who loves to be prepared ahead of time – then I want you to read this instead – how to give birth with intact perineum.)
When the tissue of the perineum have been compromised during labour, it means that your post-birth recovery will require a bit extra TLC. Make sure that the people close to you know what has happened so that they will be able to give you that extra support you need to heal.
1. Sitz Baths
This is number one for good reason, a sitz bath can reduce pain, swelling and bruising, making for quicker recovery. Your doctor or midwife has probably already recommended sitz baths, or you may have already had one at the hospital. The combination of the warm water, and the salt is very soothing and healing to the tissues of the pelvic floor. Most midwives recommend non-iodized sea salt or Epsom salts, but not too much or it will sting. Start with 1-3 tablespoons salts for each bath.
Now here’s how to uplevel your bath for even more healing. Add in gentle herbs. The easiest way of doing this is to brew the herbs into a strong tea and then add the tea to your sitz bath. Here are some lovely herbs to consider – lavender flowers, calendula flowers, oatmeal, yarrow flower, rosemary leaves. Now I get it – you’ve had 4 hours sleep and the last thing you want to figure out is herbal medicine. Here’s what I suggest, check out Earth Mama Postpartum Bath Herbs (US) and (Canada). It’s a pre-made little bag (like a herbal teabag) that you can brew. It’s good quality organic ingredients and these plants are gentle enough that you can even take your baby into the bath with you if you want. If you have stitches, you may need to angle yourself so that you aren’t pulling at the stitches.
Sitz baths work best if you do them 3 times a day for 15-20 minutes each time. Once a day get someone else to wash and sanitize the bathtub. No harsh chemicals please! Especially now that you have baby – it’s time for some healthier choices. Using natural dishsoap with 2 drops of Lemon essential oil (a word on good quality essential oils) will do the job safely and effectively. This is an important step in keeping the wound clean, since you’ll be using the tub frequently.
2. New Toilet Routine: Pat to Dry & Peri-Bottle
When you get out of the bath or after going to the bathroom – you want to go very very gently. So replace wiping with patting to dry the area. Generally the acid in the urine will burn on the wound. You can ease this by making sure to drink lots of water (so the urine isn’t as strong). Before you sit down, fill up a peri-bottle (soft squeeze or squirt bottle) with warm water and a dash of witch hazel (more on that below) and squeeze it onto your bottom as you urinate. This will ease the burning, and it will also clean the area, so that with the toilet paper you can pat rather than wipe.
3. Clean, Dry and Plenty of Fresh Air
Your bottom will heal up faster if you are able to keep it clean, dry and with access to fresh air. Of course, that’s easier said than done when caring for a newborn. Here’s my suggestion. Right after you get out of your sitz bath, go lay down on your bed for 10 minutes with NOTHING on your bottom. (Place an absorbent old towel or chux pad under you if you are still bleeding). Rest and feed your baby, or hold your baby. Remember to keep some space between your legs, so that air can reach the area. (By the way – this same concept is really important if your baby ever gets diaper rash – fresh air really helps).
Also make a conscience commitment to change your pad often and use the super absorbent maxi-pads. If you can manage a skirt and no undies once the bleeding as stopped, that is also a good option.
4. Make Padsicle (Sanitary Pad Popsicles)
This is the bomb-diggity! They are so so soothing to the perineum. Some people will erroneously tell you to soak the whole pad – that’s too much of a good thing – it will be too cold to place against your bottom. Instead spray the maxi-pad with water until it is quite damp (but not soaking), then place it in your freezer. It will act like an ice pack but more gentle (which your bottom will thank you for). The cool sensation will help to relieve the inflammation and speed healing. Use for 10-20 minutes up to every 2 hours.
First thing in the morning is a great time to use your padcicle as there tends to be a bit of swelling overnight.
To make an even more effective padcicle, add in some witch hazel (more on that below) and some of the postpartum bath herbs tea to the spray that you use to wet the pad.
5. Witch Hazel
Add in Witch Hazel. And nope, no real witches involved! Witch hazel is a natural astringent (I use it in my homemade toner) that has wonderful anti-inflammatory properties. Personally I love this organic brand (US) and (Canada)
You’ll add witch hazel in these 3 ways. First add a tablespoon into your sitz bath water. Second add a teaspoon into a 4 ounce water bottle and use this spray bottle to create your padsicle. Third you’ll use it to create your DIY New Mama Bottom Spray.
6. DIY New Mama Bottom Spray
Turn the OUCH to AHH..
This mixture will soothe and speed recovery.
Fill to half with water
1 tablespoon witch hazel
10 drops Lavender Essential Oil
10 drops Cypress Essential Oil
Top with Fractionated Coconut Oil
(Both lavender and cypress oils are excellent for use with babies. So you’ll find lots of other ways to use these two versatile essential oils. You are going to spraying this on a very delicate area – but sure you are using the highest quality essential oils – more on that here )
To use the spray – shake the blend to mix it up, and then gentle spray on the perineum. Let it air dry.
7. Relax and Move Gently
Your body has been through a lot. It needs time and gentleness to heal. Even though it may feel like there are a million things to do, your number 1 priority is to keep you and baby healthy. So let ALL the other stuff go. Treat yourself gently. Keep your activity level pretty low for the first couple weeks, then slowly ease back into increased movement, but be sure to really listen to the your body so that you don’t over do it. Take care when sitting and getting up – if you feel discomfort – slow down. If sitting is really hard, ask about a donut or special cushion, which allows you to sit without placing any pressure on the pelvic floor.
Every day take time to simply rest. You can’t always have a nap because you don’t know how long your baby will sleep for, but you can always rest when they sleep. Resting means that you lay still, soften your muscle and let your thoughts become soft and dreamy. Resting is almost as restorative as sleep – but only if you think gentle positive thoughts. To help you with this, I’ve created a guided relaxation for new moms. You can listen to a preview below. If you like what you hear, you can purchase the entire album here.
8. Eat Fiber
If ever there was a time to increase your fiber rich foods, like full grains, fruits and vegetables, now is it. This is crucial to keeping your bowel movements soft and easy. Stay well hydrated all helps a lot in this area. As much as possible avoid staining as that could put pressure on the wound.
I know I said take it easy, but kegels are the one exercise that you are ok to do right from the start. The advantage of a kegel is that you immediately increase the blood flow to the pelvic floor. This is really important, as the increase blood flow will bring nutrients and oxygen for healing.
10. Heal Emotionally
Nothing happens to us on only one level. You experience that tear or episiotomy emotionally as well as physically. Take time to really acknowledge any feelings that you might be holding onto. Some women can feel disappointed, ‘emotionally beat-up’ or even violated by the experience. I’m hoping that your care provider was kind and caring and used good communication so that you were on board with any intervention that may have occurred. However if that’s not the way things played out, spend some time working through any residual anger, anxiety or sadness.
Click here to watch my video on how to rock your pregnancy without anxiety. The video is a step by step process to releasing difficult emotions so that you can feel better.
One Final Note: Once healed the area should feel back to normal. If discomfort persists for example during loving making, then please seek out an osteopath, physiotherapist or pelvic floor specialist who can help.
Many aspects of birth are wonderful and beautiful. But for some, birth may be more accurately described as a beautiful mess. Lots of joy, lots of beauty, lots of wonder… but sometimes also unpleasant interventions, discomfort and time to heal.