What Is Postpartum Perineal Pain?

Medically Reviewed by Poonam Sachdev on April 08, 2022
Written by Victoria Hamilton
5 min read

What is postpartum pain?

Postpartum pain occurs after a woman gives birth and can have several causes.

Oftentimes, when a woman gives birth, she either tears her perineum or her doctor must make a cut in it to widen the opening of the vagina, also known as an episiotomy. Perineal tears and episiotomies result in a postpartum recovery period that can be uncomfortable or even quite painful depending on how severe the injury is.

The stretch of skin between your vagina and anus is called your perineum. During vaginal birth, this perineal area is placed under a large amount of pressure and frequently tears. To help with recovery, your healthcare provider will likely apply stitches, which will dissolve after a few weeks so that the stitches don’t need to be manually removed. It’s normal to see bits of stitches on your pad or toilet paper when using the bathroom.

If the tear is very small, you might be left to heal on your own without stitches. Depending on the length and depth of your perineal tear, though, your recovery could take four to six weeks. The pain will be at its worst right after delivery; you may have discomfort while you walk, sit, urinate, and have bowel movements for a week or so.

Remember that each woman’s body, tear, and healing process is unique. Stay in frequent contact with your healthcare provider as you care for your body.

It’s natural to be focused on your new child after you give birth, but it’s just as important to take care of yourself physically and emotionally. Keep an eye out for these normal postpartum symptoms that often come along with the vaginal soreness that is postpartum perineal pain:

  • Vaginal discharge. Your body will shed a bloody mucous membrane after delivery. Initially, it will be red and appear frequently, but after a few weeks, it will become more water-like and eventually disappear.
  • Contractions. Also known as afterpains, you’ll have infrequent contractions for a few days after you deliver your baby, especially if you breastfeed. They might feel like menstrual cramps, but they’re actually how your body compresses blood vessels in your uterus to prevent bleeding.
  • Incontinence. Your pelvic floor muscles will be stretched and worn out after pregnancy, labor, and delivery. As a result, you might leak a small amount of urine when you sneeze, laugh, cough, or do something similar. If this happens, wear sanitary pads and become educated on what pelvic floor exercises you can do to better control your bladder.
  • Hemorrhoids. If your bowel movements are very painful, check for swelling near your anus. Hemorrhoids are swollen veins in this area that cause major discomfort. Don’t avoid bowel movements for fear of making your hemorrhoids worse, though! Drink a lot of water, eat high-fiber foods, and use over-the-counter medications as needed.
  • Sore breasts. Your milk will likely come in a few days after delivery, leaving your breasts firm and tender. If you decide to breastfeed, frequently feed your baby to avoid engorgement. Nipples can be difficult for your baby to latch onto if your areolas and nipples are engorged. If they are, use your hand to pump some milk right before you feed your baby.
  • Mood swings. In a short period of time, your hormones will be constantly changing. You might feel anxious often, get sad quickly, have difficulty sleeping, or experience a number of other strong emotions. If these don’t fade within a few weeks, get in touch with your healthcare provider to talk about postpartum depression and other possible sources for your mood changes.

If you experienced a perineal tear, try these tips for managing postpartum perineal pain:

  • Hold an ice pack or something cold on your perineum to reduce swelling and pain.
  • Place a pillow or padded ring under you when you sit.
  • Put a witch hazel sanitary pad in your underwear.
  • Fill a squeeze bottle with warm water and rinse your perineum as you urinate.
  • Fill your bath with enough warm water to cover your hips and soak for a few minutes. If the warm water is uncomfortable, use cold water.
  • Use over-the-counter pain relief medication.
  • Apply numbing spray or cream on your perineum.
  • Take a stool softener or laxative to relieve constipation and make bowel movements less painful.
  • Try an over-the-counter hemorrhoid cream or suppository with hydrocortisone to treat hemorrhoids.
  • Take a warm shower or place a warm washcloth over your breast to ease engorgement pain.

Although pain is normal for someone recovering from a perineal tear, it’s not typical to have disabling or increasing pain. Such symptoms could signal an infection and should be treated immediately. Get in touch with your healthcare provider if you think your discomfort is cause for worry.

You may need to limit your physical activity until your postpartum perineal pain is fully healed. Try these prescriptions to alleviate symptoms:

  • Prioritize sleep. When you feel tired, rest if you can.
  • Walk a little each day to increase blood flow, prevent pneumonia, and fight constipation.
  • Don’t do any intense exercising, like riding a bike, jogging, lifting weights, or similar activities.
  • Avoid lifting anything heavier than your baby, if possible.
  • Pat your perineum dry after bathing or showering.
  • Hold off on driving unless your healthcare provider gives approval.
  • Abstain from sex until your healthcare provider does a checkup and tells you that you’ve completely healed.

As you recover from giving birth, be cautious and conscious of your condition. If something feels wrong, get in touch with your healthcare provider immediately, just to be safe. While discomfort is normal, it’s part of the healing process and your symptoms shouldn’t get worse. See a healthcare provider if:

  • You have heavy vaginal bleeding that requires you to change your pad more than once an hour.
  • You pass blood clots that are larger than a quarter.
  • You develop chills and a fever of greater than 100.4℉.
  • You continually feel faint or dizzy.
  • You have intense headaches that won’t go away.
  • Your vision changes.
  • Your vaginal discharge has a strong, unusual smell.
  • You have chest pain, heart palpitations, or difficulty breathing.
  • You vomit regularly.
  • Your tear or incision is swollen and has pus.
  • You have stomach pain that doesn’t get better.
  • Your breasts turn red and feel hot.
  • You have leg pain accompanied by redness and swelling.

Be patient during your postpartum recovery. Seek help from friends, family, or professionals if you have reason to worry or feel like you’re unable to care for yourself.