Caring for Your Bottom After Birth

Your perineum is the vagina, the rectum, and the skin in between. While giving birth, the skin between the rectum and vagina must stretch and open for the baby to pass. Many times, this skin stretches and allows the baby to pass and then goes back over the next few days and weeks. For some women, the skin will tear when the baby passes; others will have an episiotomy or cut in their skin to let the baby pass through with more ease. After a woman gives birth, some swelling is normal. 

The vagina and the skin around the rectum begin to heal right after birth. It takes about 3 to 4 weeks for the vagina and rectum to get back to what they were before birth. Complete healing can take weeks or months. There are things you can do to help while your body is healing. 

A sudden increase in your pain or bleeding could be a warning. Please call your midwife or doctor to report changes. 

Things that can help a sore bottom: 

• Use a squirt bottle filled with warm water every time you go to the bathroom. Squeeze the bottle of water on your bottom while you urinate. This will make the urine waterier so it will not burn as bad. Also, use the water bottle to spray your rectum after a bowel movement. Then use a clump of bathroom tissue to blot or pat your bottom dry, do not pull at tender skin or stitches. 
• Use an ice pack or ice bag as needed for 30 minutes at a time. You can use a chemical ice pack or ice placed in a bag or glove with a rubber band to hold it shut. Wrap the ice pack with a soft cover that can soak up blood or moisture, and place the ice bag against your bottom.
• You can also saturate maxi pads and freeze them for a disposable ice pack.
• Use a sitz bath 2 or 3 times daily. Use a sitz that fits in your toilet or get on your knees in the bathtub letting the water flow around your bottom. A sitz bath can be cool or warm but not hot. A cool sitz bath or has ice can help with pain and reduce swelling. 
• Witch hazel pads reduce swelling and relieve pain. You can buy witch hazel at the drug store. Pour witch hazel on 4x4 gauze pads; squeeze out the pads, so they are wet but not dripping, and place them on your vagina or rectum. You can buy pre-made pads at the drug store (Tucks®). 
• You can buy pain relief spray at the drug store. These sprays help to numb the skin and relieve pain, such as Dermoplast® or Americaine®; if you need to use this spray for more than a few days after having your baby, please call your midwife or doctor. 
• Tighten the muscles between your vagina and rectum when you change position or when you will have direct pressure on your vagina, rectum, or stitches. Tighten your muscles so that you can feel your bottom pulling up and in, hold your muscles tight while you move in and out of bed, or sit in a chair. 
• Pain pills by mouth are also helpful with pain in your bottom. You may use Tylenol® and Motrin® as directed on the bottle or meds ordered by your midwife or doctor. Aspirin should only be used if you are not breastfeeding your baby. 
• Drink plenty of non-caffeine fluids. 
• You can buy creams or ointments from the drug store for hemorrhoids; examples are Preparation H® or Anusol Suppositories®. These medicines help to shrink the swollen blood vessel and numb the pain. 
• Stool softeners and laxatives can make stool softer and easier to pass to not bother the swollen blood vessel. Stool softeners you can buy at the drug store are Colace®, fiber tablets, or Metamucil®. Be sure to drink plenty of fluids with these meds.