You’ve gotten through childbirth (and officially welcomed your baby to the world!) — but you’re likely not entirely out of the woods when it comes to pain post-delivery.
Pushing a baby through a relatively small opening can lead to some tenderness and swelling after giving birth. And if you experienced any tearing in your perineum, the area between your vagina and anus, or if the doctor performed an episiotomy to widen your vaginal opening, you could be hurting for a little while longer.
Here’s what you should know about what causes perineum pain, what’s normal and what’s not, and how to ease perineal pain after birth.
What is perineum pain?
Perineum pain is one of the most common types of postpartum pain (along with the kind that accompanies breast engorgement and uterine contractions).
The length of tissue and muscle separating a woman’s vaginal opening from her anus, aka the perineum, is designed to stretch. But it’s not quite as accommodating as the vagina. Under the intense pressure of a baby’s head pushing up against the vaginal opening during labor, the perineum can get swollen and sometimes even tear.
In certain circumstances, the doctor delivering your baby may need to perform an episiotomy, a procedure that involves making a surgical incision in the perineal tissue to widen the vaginal opening. An episiotomy is no longer routine, but sometimes it’s necessary to help your little one make an exit.
So suffice it to say that your nether regions can be quite sore and sensitive after giving birth.
What causes postpartum perineum pain?
Every woman’s experience is different, of course, but the causes of postpartum perineum pain and how long it lasts usually depend on how you delivered:
Vaginal birth without tears: The entire perineal area and rectum may be swollen after a vaginal birth, and you’ll likely feel discomfort in the area for several weeks.
Vaginal tear or an episiotomy: The wound will begin healing immediately, but it often takes several weeks for healing to be complete and for soreness to resolve.
C-section following labor: Depending on how long you pushed before having a C-section and whether your baby’s head came close to crowning, expect some discomfort after birth.
How much vaginal pain is normal after giving birth?
You just brought a tiny human into the world, so a certain amount of discomfort is perfectly normal. It’s going to take time to make a full recovery after having a baby, whether or not you had perineal tearing or an episiotomy.
However, if any of the following symptoms surface, contact your doctor right away. They could be signs of a postpartum infection:
Worsening pain
Increased warmth, redness or swelling at the site of the tear or incision
Fever
A discharge of pus
Strong or unpleasant odor
How do you relieve postpartum perineum pain?
The following strategies and tips can help relieve perineal pain after birth, no matter how you delivered:
Keep it clean. Spray warm water over the area with a squirt bottle during and after going to the bathroom to keep your urine from irritating the skin.
Chill out. Apply ice to the area for 10 to 20 minutes every few hours after childbirth to minimize pain and swelling. Icing the area may also provide pain relief over the first few days post-delivery. Pro tip: A surgical glove filled with crushed ice makes a great ice pack.
Make “padsicles.” Some moms swear by this DIY trick for postpartum relief. What you’ll need: overnight maxi pads, a spray bottle, alcohol-free witch hazel and aluminum foil. Lay the pads on a sheet of foil and spray with witch hazel until damp. Wrap each pad in foil and stow in the freezer to cool. When you need soothing relief, grab a padsicle, remove the foil and use it like you would an ice pack.
Go for a warm soak. Find relief by submerging your sore lower half in a sitz bath (a shallow basin filled with warm water) for up to 20 minutes at a time. It soothes the skin and boosts circulation to the area. If a sitz bath is uncomfortable, or if you don’t have a basin, you can soak your bottom in the bathtub. Just make sure to keep the water shallow (no more than 3 inches deep). Bonus: It’s good for hemorrhoids too.
Apply a warm compress. A clean washcloth or towel dampened with warm water serves the same purpose as a sitz bath soak. Hold it against your perineum to ease discomfort.
Consider a numbing agent. Ask your health care provider if it’s safe for you to use a topical pain reliever like a numbing spray or cream.
Ask about oral analgesics. If you’re not already popping an over-the-counter or prescription pain reliever, check with your doctor about whether you can take acetaminophen (Tylenol) or a nonsteroidal anti-inflammatory medication, such as ibuprofen (like Advil or Motrin), to take the edge off. Be sure your provider knows whether or not you're breastfeeding.
Baby your bottom. Invest in a donut pillow (with a hole in the center) to take the pressure off your sore bits while you’re sitting. And recline when you can!
Let it breathe. Now is not the time for leggings, jeans or underwear that grips. You don’t want your clothing rubbing you the wrong way, so to speak. Instead, break out the loosest, most comfy sweatpants you own.
Stay regular. If difficult bowel movements are a problem (the problem being you're dreading the pain of passing them), drink lots of fluids. You can also try eating more fiber, which will help move things along more smoothly. Or ask your practitioner about a stool softener or mild laxative for constipation.
When to talk to your doctor about postpartum vaginal pain
Still having pain down under more than six weeks after delivery? Make sure to mention any lasting soreness or irritation to your doctor at your next postpartum checkup.
If your pain is accompanied by signs of infection or other concerning postpartum symptoms, it’s time to seek medical attention. Your vaginal pain could be a sign of bacterial vaginosis, a common infection that produces a foul-smelling discharge, or potentially something more serious.
It’s also possible that in pushing your baby out, you developed hemorrhoids or even anal fissures, which can range from uncomfortable to extremely painful but will heal with care and time.
Note: Call your doctor or 911 (or just head to the nearest emergency room) if you experience any type of extreme pain or have symptoms including heavy bleeding, severe headache, chest pain or difficulty breathing. These can be warning signs of several different life-threatening conditions that can occur after giving birth.
As for soothing your perineal pain? Having several go-to, pain-relieving strategies at the ready before you give birth will make your recovery that much easier.
Yes 
No 
Trending On What to Expect
