Perineal and stitches care after birth

After a vaginal birth, your perineum (the area between the vagina and anus) is often sore, whether or not you had stitches — it’s done a huge amount of stretching. If you had a tear or episiotomy that was stitched, it needs a little care as it heals. The good news: most heal well within a few weeks. Here’s how to look after yourself and stay comfortable.

What to expect. The area will likely feel sore, swollen and tender for the first days to weeks, and stitches can sting, especially when weeing. Stitches are usually dissolvable and don’t need removing — they disappear on their own over a few weeks. Discomfort should gradually improve, not worsen, as you heal.

Keeping the area clean. Good hygiene helps prevent infection:

Change your maternity pad regularly and wash your hands before and after.
Shower daily and gently clean the area with warm water (no need for harsh soaps); pat dry rather than rubbing.
A squirt of warm water (from a peri bottle or jug) over the area while you wee dilutes the urine and reduces stinging — a genuine game-changer.

Easing the pain. Comfort measures make a big difference:

Cold packs (a wrapped ice pack or a chilled pad) on the perineum in the first days reduce swelling and pain.
Simple pain relief like paracetamol (and ibuprofen if suitable — check if breastfeeding) helps; ask your midwife or pharmacist.
Sit comfortably — some people find a soft cushion or rolled towel helps; move position often rather than sitting rigidly.
Pelvic floor exercises (gentle squeezes) actually boost blood flow and healing and are worth starting early, as comfort allows.

Weeing and pooing. The first poo can feel daunting — you won’t tear your stitches. Stay hydrated, eat fibre, and don’t strain; a footstool (knees up) helps, and holding a clean pad gently against the stitches for support can ease the worry. Ask about a stool softener if you’re constipated (common after birth). Weeing may sting at first — the warm-water trick helps.

Signs of infection — get checked. Contact your midwife, GP or maternity unit if you notice: increasing pain, redness, swelling or heat around the stitches; a bad smell or unusual discharge; the wound opening up; pus; a fever or feeling unwell; or if pain is getting worse rather than better. Infections are treatable, and early care matters.

When healing is slow or painful long-term. Most perineums heal within a few weeks, but see your GP or ask for a women’s-health physiotherapist if you have ongoing pain, pain with sex, a feeling that something isn’t right, or any leaking of wind or urine beyond the early weeks. These are common, very treatable, and much better addressed than endured. Raise anything at your 6-week check.

Be patient and rest. Healing takes energy, so rest as much as a newborn allows, avoid heavy lifting, and don’t rush back into activity. Your body has done something enormous; give it time and care.

Haemorrhoids often come along too. Many people also have haemorrhoids (swollen veins around the back passage) after birth, which can be sore or itchy alongside the perineal soreness. The same measures help — cold packs, not straining, fibre and fluids, and a gentle wipe or wash — and your pharmacist can suggest a pregnancy/breastfeeding-safe cream. They usually settle over the following weeks; see your GP if they’re very painful, bleeding a lot, or not improving.

Caring for your perineum after birth comes down to keeping it clean and dry, using cold packs and pain relief, the warm-water-while-weeing trick, gentle pelvic floor exercises, and not straining on the loo. Watch for signs of infection, raise any lasting pain or leaking with your GP or a physio, and be kind to yourself while you heal — most people are comfortable again within a few weeks.