Perineal Pain

Dec 31, 2010 No Comments by
“I didn’t have an episiotomy, and i didn’t tear. Why am i so sore down below?”
You can’t expert some 7 pounds of baby to pass unnoticed. Even if your perineum was left neatly intact during the baby’s arrival, that area has still been stretched, bruised, and generally traumatized, and discomfort, ranging from mild to not so mild , is the very normal result. The pain may be worse when you cough or sneeze, and you may even find that it hurts to sit down for a few days. You can try the same tips given  in the next answer for women with post-tear pain.
It’s also possible that in pushing your baby out, you developed hemorrhoids and, possibly, anal fissures, which can range from uncomfortable to extremely painful.
“I tore during delivery and now i’m incredibly sore. Could my stitches be infected? “
Everyone who delivers vaginally (and sometimes those who have a lengthy labor before delivering via cesarean) can expect some perineal pain. But, not surprisingly, that pain’s likely to be compounded if the perineum was torn or surgically cut (aka an episiotomy). Like any freshly repaired wound, the site as a laceration or episiotomy will take time to heal, usually 7 to 10 days. Pain alone during this time, unless it is very severe, is not an indication that you’ve developed an infection.
What’s more, infection (though possible) is really very unlikely if your perineal area has been well cared for since delivery. While you’re in the hospital or birthing center, a nurse will check your perineum at least once daily to be certain there is no inflammation or other indication of infection. She’ll also instruct you in postpartum perineal hygiene, which is important in preventing infection not only of the repair site but of the genital tract as well (germs can get around). For this reason, the same precautions apply for those who delivered completely intact. Here’s the self-care plan for a healthy postpartum perineum:
  • Use a fresh maxipad at least every four to six hours.
  • Pour or squirt warm water (or an antiseptic solution, if one was recommended by your practitioner or nurse) over your perineum while you pee to ease burning, and after you’re done on the toilet, to keep the area clean. Pat dry with gauze pads or with the paper wipes that come with some hospital – provided sanitary pads, always from front to back.Gently does it – no rubbing.
  • Keep your hands off the area until healing is complete.

Though discomfort is likely to be greater if you’ve had a repair (with itchiness around the stitches possibly accompanying soreness),the suggestion below will likely be welcome no matter how you delivered. To relieve perineal pain:

Ice it. To reduce swelling and bring soothing relief, use chilled witch hazel pads, a surgical glove filled with crushed ice, or a maxipad with a built-in cold pack, applied to the site every couple of hours during the first 24 hours following delivery.
Heat it. Warm sitz bath (a bath in which only your hips and buttocks are submerged) for 20 minutes a few times a day or hot compresses will ease discomfort.
Num it.  Use local anesthetics in the form of sprays, creams, ointments, or pads recommended by your practitioner. Acetaminophen (Tylenol) may also help.
Keep off it. To keep the pressure off your sore perineum, lie on your side when possible, and avoid long period of standing or sitting. Sitting on a pillow (especially on with an opening in the center) or inflated tube (usually marketed to hemorrhoid sufferers) may also help, as can tightening your buttocks before sitting.
Keep it loose.  Tight clothing, especially underwear, can rub and irritate the area, plus slow healing. Let your perineum breathe as much as possible (for now, favor baggy over spandex leggings).
Exercise it. Kegel exercises, done as frequently as possible after delivery and right through the postpartum period, will stimulate circulation to the area, promoting healing and improving muscle tone. Don’t worry if you can’t feel yourself doing the Kegels; the area will be numb right after delivery. Feeling will return to the perineum gradually over the next few weeks – and in the meantime, the work’s being done even if you can’t feel it.
If your perineum becomes very red, very painful, and swollen, or if you detect an unpleasant odor, you may have developed an infection. Call your practitioner.

After The Baby Is Born, Postpartum:The First Week
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