Your perineum this and stretches when you birth vaginally, and you may have grazes or tears down into the perineum, into the labia minora, or up toward the urethra and clitoris.
You can read more about degrees of tearing here.
If you have a tear that requires sutures, the sutures that both midwives and doctors use in Aotearoa are dissolvable. Depending on the type of suture, they will dissolve in 1-2 weeks or 2-3 months. If you have a more severe tear, then the doctors doing the repair will generally use a longer-lasting suture material.
If you have any tearing or swelling of the perineum after birth, applying an ice pack for 5-10 minutes every 2-3 hours can help reduce the swelling and increase your comfort.
Passing urine when you have any perineal or vulval damage can sting! To reduce this, stay well hydrated (at least 2-3L of water per day), as concentrated urine can sting more. Pouring warm water over your grazes, tears, or sutures while passing urine can reduce the stinging, or passing urine while in the shower or sitting in a shallow bath. Leaning forward while passing urine can help if the damage is mostly to your perineum, as this will direct the urine away from the sore spots. After passing urine, pat rather than wipe!
Passing stool can also be painful, especially if you have needed sutures. Staying well hydrated and eating plenty of fibre will soften your stool and make it easier to pass, but if it is still hard and painful, please ask your midwife for prescription laxatives. It can help to support your stitches with a clean piece of toilet paper while passing stool, and putting your feet on a footstool to raise your knees above your hips can also help.
To keep your wound or stitches clean and healthy, shower at least once a day, wash the area with water only, and pat dry gently. Change your pad regularly to help keep the area dry and prevent infection.
Regular pain relief can help with any pain in the area, and paracetamol and ibuprofen are safe to have if you are breastfeeding. Ibuprofen will also help with any swelling.
Try to avoid sitting or standing for too long, as this can increase swelling – side lying is often a good comfortable position. Try to start pelvic floor exercises as soon as you are comfortable to after birth, as this area has stretched, which can cause incontinence as it is the pelvic floor that controls bladder and bowel function. Early resuming of pelvic floor exercises will help to area heal well as it encourages good blood flow.