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Pushing a human through your birth canal can and will leave you with some tenderness at best and some pain at worst. Here are some simple tips to help ease discomfort and heal your perineum so that you can be pain-free while caring for your newborn.
First of all, what is the perineum?
The perineum is the area between your vaginal opening and the anus. For some people, it tears when they give birth. Tears can also occur inside the vagina, vulva, inner labia, and outer labia which can lead to pain and discomfort postpartum.
If you had a naturally-occurring tear or if your doctor or midwife made an incision, it is possible that you might feel some perineal pain for a few weeks.
To manage perineal pain:
Avoid sitting on hard chairs. Sit on padded rings like a swim ring or pillows. Some people even prefer to sit on a nursing pillow like a Boppy.
Ice your perineum for 20 minutes at a time several times a day.
Sit in a shallow bath of warm water (sitz bath) for 5 minutes a day.
Consider wearing a sanitary pad with chilled witch hazel or prep some padsicles.
Use over-the-counter topical pain relief provided by your doctor.
Related: DIY Padsicles for Postpartum Mamas
Hemorrhoids and Bowel Movements
Hemorrhoids are swollen veins in the lowest part of your rectum and the anus, often causing rectal bleeding. They can be internal or external. Sometimes with pushing during a vaginal birth, hemorrhoids can flare up and then become uncomfortable in the following days postpartum.
If this happens, try:
15-minute warm water perineal soak 2-3 times a day
Padsicles for tenderness
Over-the-counter hemorrhoid cream with hydrocortisone
After giving birth, it's not uncommon to be nervous about going poop for the first time postpartum because of fear that it will hurt or irritate the perineum. It is also not unusual to experience constipation postpartum. On average, women have their first bowel movement up to 3 days after giving birth. There are a variety of reasons why women experience constipation postpartum, and it is important to remember that "a normal bowel movement" means something different for everyone. Focus on how you feel, and know that constipation is common. If a week goes by and you still have not gone, contact your doctor or midwife.
Ways to Relieve Constipation
Drink lots of liquids like water, hot ginger tea, and coconut water.
Load up on fruits and vegetables, especially berries and leafy greens.
Eat fiber-rich foods like oatmeal, nuts, bran, whole grain, and the infamous prunes! (Tip: Soak the prunes in water first so that they don’t draw more fluid out of your GI tract.)
Try not to sit for too long. Regularly get up and move around or walk.
If needed, try a gentle stool softener approved by your doctor or midwife.
Vaginal birth will stretch your pelvic floor muscles, uterus, bladder, and rectum. Even if you had a c-section, your also have experienced changes to your pelvic floor. It happens with all pregnancies. With that, incontinence is not uncommon. You might notice a little urine comes out when your cough, sneeze, or laugh those first weeks after birth. Remember, pads are your friend! It's important to keep your perineum clean and dry to avoid infection as well. Some women like to use period panties postpartum to help absorb any leakage that might occur. Others prefer disposable Depends (which do a great job covering all of your bottom to catch any postpartum bleeding or discharge) so they can just toss a pair in the trash. Plus it cuts down on their laundry loads. As your perineum starts to heal, you can begin to do some Kegels, but only if you are not experiencing pain. Sometimes it's just a little pee, and sometimes, well, it's something else. This can be frequent if you had a severe tear. It is important to contact your care provider if your symptoms do not gradually improve postpartum.
After the baby comes, you will shed the superficial mucous membrane that has lined your uterus for the past 9 months. This discharge will be a thick mucus-like substance with blood. The blood will be red and heavy for the first few days and then will taper off to a pinkish/brown color, as a period would. Postpartum bleeding and discharge, called lochia, can last for several weeks to a month or more. The length of time varies person to person.
New parents tend to ignore their physical needs to focus on the baby for those first few weeks – well, years, really! You can indeed kiss goodbye to always sleeping in or sitting down for a meal. That's normal. However, it's crucial to pay close attention to how you feel and how your perineum is healing. Failure to do so may lead to infection or further problems and delayed treatment, which can be painful and sometimes dangerous. Keep the area clean and dry, sit in a warm soak 2-3 times a day, and remember – padsicles are your friends!
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