Perineal care after delivery

Following delivery many women will have small tears involving the perineum - the area between the vaginal opening and the anus. Please read this section if you had a tear or an episiotomy (a cut) to create space for the delivery of your baby.

This information is particularly important if you had a more extensive tear involving the muscle of the anus (3rd degree tear) or into the lining of the rectum (4th degree tear).

The type of tear and its degree will be explained to you when it is repaired.

What happens in the days and weeks following repair?Show [+]Hide [-]

To avoid pressure on the wound in the first few days it is best to avoid sitting for long periods and to lie on your side. If you are breastfeeding your midwife will show you comfortable positions for you and your baby.

To speed up healing and prevent infection keep the area clean. Have a warm, not hot, bath or shower at least once a day and pat the area dry to keep it free of moisture. Bubble bath may irritate and delay healing. You may have heard that salt added to bathwater helps but salt can make the stitches break down too quickly. Change your sanitary pad regularly washing you hands before and after you do so. Seek advice if there are signs of infection - an increase in pain or an offensive discharge.

Foods containing fibre

Constipation causes straining and pressure on the recovering tissues. To help prevent this, please eat plenty of foods containing fibre such as brown rice, cereals and fruit. Try to drink about two to three litres of water each day. This helps stools to be softer and easier to pass.

For a 3rd or 4th degree tear laxatives are prescribed for the first 10 days to soften your stools and make them bulky and easier to pass. The aim is not to cause diarrhoea which may cause leakage. We also recommend five days of antibiotics for a 3rd or 4th degree tear to reduce the risk of infection.

Before you go home we suggest that any stitches are checked and that you have been able to comfortably open your bowels. Stitches usually dissolve by 10 days although sometimes portions can persist for longer. All stitch material will eventually dissolve. Often the stitches around the anus remain in place for up to 12 weeks and can make passing bowel motions uncomfortable. Avoid constipation and if the pain is intense or you lose blood with the stool seek advice.

Rarely a connection forms which  allows unexpected leakage of faecal material from the vagina. This is not common and you should always seek advice. The connection (fistula) can usually be repaired if it does not heal spontaneously.

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