Monday, December 29, 2014

Perineum Postpartum Care

I researched healing methods and obtained any necessary items to help get me through the healing process after birth. Some of the following are techniques to promote this healing, and others are products I had on hand in case they proved useful.


If you have had stitches or a tear, baths are recommended at least once a day. I personally found these to be helpful for relieving engorgement after my milk came in as well.

Soak in a clean tub filled with several inches of warm water. You can add half a cup of epsom salts and, after the first three days, you can also add herbs that are known to promote wound healing (i.e. calendula or comfrey). After bathing, allow time for your perineum to be exposed to the air as this also promotes healing: lie down on a towel or pad for around 30 minutes, or use a hand held hair dryer on a warm setting. The normal healing process for stitches or tears progresses from tenderness in the first days to slightly itchy.

I planned to only use epsom salt, and found these to be enough. If you really enjoy scented baths, a few interesting options I've seen available for use in healing baths are:

Use of water and perineal sprays

Your perineum will likely be sore and tender for the first days after the birth, which can cause discomfort when urinating. To help, you can squeeze warm water onto your perineum with a plastic squeeze bottle every time you go to the bathroom to take the sting out of it. You can also use a peri or spray bottle filled with witch hazel or a mix of healing ingredients. There are many available pre-made, or you can easily mix your own.

The peri bottle is also useful for preventing infection. Use it to rinse the area with warm water after each urination or bowel movement, then pat yourself dry from front to back to minimize irritation and discomfort.

I chose to have Earth Mama Angel Baby New Mama Bottom Spray on hand, however I ended up only using the peri bottle. I found having two to be helpful so I could keep them in the two bathrooms I use most often in the house, as my midwives also recommended that I try to avoid going up and down the stairs in the first couple of days.

Perineum cream

Many people simply apply witch hazel directly using a peri bottle as detailed above, but there are a couple of other options that may be more soothing. Creams can be stored in the refrigerator, which can also help cool the area when applied. I decided to get Earth Mama Angel Baby New Mama Bottom Balm, which contains natural ingredients such as shea butter and witch hazel leaf. There are quite a few options for this as well, but the ones I considered:
I enjoyed using Earth Mama Angel Baby New Mama Bottom Balm, though I didn't bother keeping it refrigerated. You spend a lot of time sitting and nursing in the first few days, and it felt good when applied.


Warm and cold compresses can help ease discomfort. Some midwives recommend warmth as it brings blood to the area. In fact, in some traditional cultures postpartum women are not allowed anything cold and are kept in very warm rooms. To apply a warm compress, just use a washcloth.

If you prefer cold, fill a plastic bag with crushed ice and wrap it in a wash cloth. You can gently apply an ice pack to the perineum for 20 minutes every two or three hours, especially in the first 24 hours, to reduce swelling and relieve pain. Many women I've spoken to also swear by Padsicles, which are pads that have been soaked with witch hazel and aloe vera and frozen. 
I didn't find I needed to do this as I had minimal discomfort. Had I not been able to take daily baths and showers, I probably would have resolved to doing it.

Maternity and menstrual pads

And then there's the bleeding. Most online resources recommend absorbent pads without a mesh cover to prevent irritating stitches. Ideally, they should also not have a plastic liner to ensure the area can breathe. I purchased a few different kinds:
And for slightly lighter flow:

There are also many natural cloth options available. A thorough review of these is available at Maman Loup's Den.

I ended up using the Organ(y)c ones the most, and alternated depending on time of day for the first few days. I found the maternity pads rather thick, which was uncomfortable when spending hours sitting with baby, and preferred the Organ(y)c 100% Organic Cotton Pads with Wings - Heavy Flow to the maternity ones in the end. Within a few days I switched to using Natracare panty liners that I already had on hand, but I didn't really like them as they were very small and still somewhat thick. I'd recommend having some on hand that are larger and very very thin.

Comfortable underwear

Goes without saying that between compresses, pads and bleeding you'll also want to ensure you have comfortable underwear that breathes and that you can happily dispose of after birth. I meant to purchase inexpensive cotton underwear in a size too big, but ran out of time so instead I set aside some comfortable underwear that I'm ok needing to replace. I also obtained samples of those god-awful incontinence panties: Tena and Depends. If you visit their websites each will send you two pairs you can give a try. I didn't end up needing these postpartum, however they were a godsend during labor given that my water broke 24 hours before I went into early labour!

The other option is disposable underwear and/or mesh panties. Hospitals apparently give these out. I couldn't find any mesh undies with good reviews online though, that matched the quality of the hospital ones, so you might be better off making friends with nurses or sticking to the above choices as I have.

Pain relief

Both Acetaminophen (Tylenol) and Ibuprofen (Advil) are safe and recommended for pain management in the postpartum period. Try acetaminophen first, then ibuprofen if you need something stronger. Our midwives recommended taking two regular strength Tylenol and Advil every 4 hours, which I found to be the best pain relief during those first few days and long evenings spent holding and nursing baby. I don't usually take any pain relief drugs, but I found these to be the best item to have on hand. I took them around the clock the first three days and every night for the following week or so. It made all of the difference.

One of many great Canadian online retailers for labour and postpartum care is the All About Birth Boutique. They have many natural products and a section dedicated to postpartum care.

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