The perineum is the area between your vagina and anus. It stretches during childbirth and may become bruised, grazed, or torn. You may also have a surgical cut (episiotomy) to help deliver your baby.
Many women experience some degree of perineal trauma during vaginal birth. Your perineal area will normally feel tender and sore after giving birth whether or not you have had stitches.
We recommend your midwife looks at your perineum daily whilst you are in hospital and at each community midwife check. This is to monitor healing and detect any signs of infection. You may also consider visualising your perineum during the antenatal period to familiarise yourself with your anatomy.
Common Types of Perineal Trauma
| Type | Description |
|---|---|
| Grazes or bruising | Mild, usually heals quickly |
| First degree tear | Affects skin only |
| Second degree tear | Involves skin and muscle |
| Third or Fourth degree tear | Involves the muscle and skin around anus |
What You Might Feel
- Soreness or stinging, especially when sitting or passing urine
- Swelling or bruising in the area
- Stitches may feel tight or itchy as they heal
These are normal but can be uncomfortable for several weeks.
How to Care for Your Perineum
- Wash your hands before and after touching your perineal area.
- Gently clean the area daily with warm water (no need for soap).
- Rinse with water after using the toilet — a water bottle or perineal spray bottle can help.
- Pat dry gently from front to back.
Keep the Area Dry
- Change sanitary pads every 2 – 4 hours.
- Wear cotton underwear and avoid tight clothing.
- Give your perineum some time “to breathe” – lie down with no underwear for short periods.
Pain Relief and Comfort
- Paracetamol can help with wound pain and anti inflammatory drugs such as ibuprofen can help reduce swelling, both are safe to take while breastfeeding. Please read the label carefully and administer as per manufacturer’s instructions.
- A cool gel pad or wrapped ice pack may reduce swelling (10–15 minutes max).
- Pouring warm water over the area while urinating can reduce stinging.
If You Have Stitches
- Stitches usually dissolve within a few weeks.
- You may notice some threads as they break down, this is normal.
- Avoid long baths in the first week (showers are best early on).
When to Seek Medical Advice
Contact your midwife, GP, or Maternity Triage if you experience:
- Increased pain or swelling
- Foul-smelling discharge
- Fever or chills
- Separation of stitches or bleeding
- Difficulty passing urine or stools
- Loss of control of bowels or wind
Pelvic Floor Exercises
The pelvic floor muscles assist in preventing leakage of urine, wind and stools. During birth they are stretched and may be weakened. Doing gentle pelvic floor exercises daily can help with healing and reduce long-term problems like incontinence.
You may find the NHS Squeezy app useful for learning how to do pelvic floor exercises correctly. You can find this app at nhs.uk within the apps library under Squeezy.
Emotional Wellbeing
Some women feel upset or distressed about their birth experience or trauma. This is completely valid. Talk to your midwife, GP, or health visitor. Support is available, NHS Forth Valley facilitate a Birth Conversations Clinic which may be suitable for you.
Contact Information
Midwifery Triage: 01324 567098
GP Out of Hours (NHS24): 111
Community Midwives / Health Visitors: Contact via your red book or local hub