How to ease postpartum pain

Giving birth is one of the most amazing, miraculous, scary and downright painful experiences you can have in life. Certainly, your new bundle of joy is worth every ache. But delivering a baby can cause everything down there to be sore and tender.

This is true whether you had an uncomplicated vaginal birth, an episiotomy or a C-section.

The pain — known as perineum pain — can make everything from walking and sitting to using the toilet difficult.

The good news: You can ease your pain and help your body’s healing process. Then you can focus on what’s really important: bonding with your new baby. Here’s what you need to know.

Perineum pain 101

In women, the perineum is the area between the vagina and the anus. Trauma to this area is very common during childbirth, says Rachel Taylor. She is a postpartum registered nurse and childbirth educator in Birmingham, Alabama.

The perineum can be injured during childbirth in several ways, including:

• Stretching. The birth canal widens as your body prepares for delivery.

• Tearing. The tissue around your perineum and vagina stretches and tears during delivery. This can happen if your baby is very large, you have a quick delivery or the doctor uses forceps, according to the Cleveland Clinic.

• Episiotomy. This is a surgical cut in the perineum that a doctor makes during labor to help widen the opening of the birth canal. Episiotomies are sometimes necessary if your baby needs to be delivered quickly, according to the Mayo Clinic (e.g., the baby’s shoulder is stuck behind your pelvic bone, or the baby has an abnormal heart rate).

• Stitches. The doctor stitches up the perineum after the baby is born to help the tears or episiotomy heal.

“Most women are surprised at how uncomfortable they are after they’ve delivered a baby,” says Taylor. In addition to the natural stretching and tearing, new moms can also experience symptoms such as:

• Bruising
• Hemorrhoids
• Pain and swelling in the vaginal and anal areas

Tracking your perineum pain symptoms

After your baby’s birth, keep an eye out for symptoms that could signal infection. Things to watch for:

• Perineum pain that’s getting worse
• An unpleasant or foul odor
• A fever
• White pus or a yellowy discharge

Call your doctor if you experience any of these symptoms. They’ll want to examine you to determine what’s causing your pain and how best to treat it.

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How to soothe perineum pain at home

Even if you don’t have any complications, your vaginal area will be sore after childbirth. Your doctor might recommend these home remedies:

Ice the perineum. Ice packs or cold gel packs are lifesavers in the first few days after you give birth, says Heather Jeffcoat. She is a physical therapist in Los Angeles, California. Jeffcoat specializes in women’s health and is the founder of Femina Physical Therapy. You can also chill maxi pads in the freezer or wear a small ice pack in your underwear with your maxi pad.

Use a squirt bottle. After you use the toilet, take a squirt bottle filled with warm water and rinse the entire vaginal and anal areas. Gently pat the areas dry (rather than rubbing or wiping) with toilet paper.

Try witch hazel. Dab your perineum with witch hazel every time you change your pad. It’s an astringent that reduces inflammation and the chance of infection. Pre-soaked witch hazel wipes are handy to keep in the bathroom.

Take sitz baths. A sitz bath (sitting in warm, shallow water for 5 minutes) can relieve soreness, according to the American College of Obstetricians and Gynecologists. Keep in mind that new moms should avoid full-body baths before their first postpartum checkup. Stick to showers instead, recommends Taylor.

Plop down on a pillow. A special “donut” pillow allows you to sit comfortably because it takes the pressure off your vaginal area. You can also sit on a breastfeeding pillow.

Keep your stool soft. Straining to make a bowel movement can increase your perineal pain. It can even pop your stitches if you had an episiotomy. Drink plenty of water and ask your doctor if you should use a laxative or stool softener to clear up any constipation. (You can order one from the Optum Store.)

Try over-the-counter topicals. Ask your OB-GYN if it’s okay to try a pain relief spray that contains lidocaine. These sprays can temporarily numb the area. (Warning: “Never use an ice pack at the same time as lidocaine,” says Taylor. It could damage the skin.) You can also try applying hemorrhoid cream, which shrinks swollen tissues and reduces discomfort. “Keeping the tube in the refrigerator will help provide instant relief,” says Taylor.

Shop for all your baby and new-mom needs on the Optum Store and have products shipped directly to your front door.

The benefits of perineal massage

Want to lower the risk of tearing during childbirth? Doing perineal massage during the last few weeks of pregnancy can reduce the need for an episiotomy, according to the American Pregnancy Association. (This advice could come in handy if you decide to have another child.)

Massage helps stretch the muscles and reduce perineal trauma. It can also lessen perineal pain in women who’ve previously delivered a baby vaginally. Try massaging the area using coconut or almond oil. Tough reach? Ask your partner to lend a hand.

When will I be able to have sex again?

Your doctor will give you the go-ahead to have sex after your perineum has healed. This can take 4 to 6 weeks or even several months. But just because the doctor says it’s safe doesn’t mean sex will feel the same. “Post-pregnancy hormonal changes can cause perineum discomfort, and so can sensitive scar tissue,” says Jeffcoat.

Finding a lubricant that works with your body is a good first step. Your doctor can also refer you to a pelvic floor physical therapist, who can teach you some exercises to help heal the area. It might be a while before you feel like having sex again — and that’s okay.

The most important part of your postpartum recovery is allowing your body to heal and to focus on your new role as a mom. In time, your body will tell you when it’s ready to get busy again.

(Keep in mind that you can still get pregnant during this time. If you need birth control, the Optum Store can help — no insurance needed.)

Additional sources
Tearing: Cleveland Clinic (2020). “Vaginal Tears During Childbirth”
Episiotomy: Mayo Clinic (2020). “Episiotomy: When It’s Needed, When It’s Not”
Sitz baths: American College of Obstetricians and Gynecologists (2020). “Postpartum Pain Management”
Perineal massage: American Pregnancy Association (n.d.). “Perineal Massage During Pregnancy”