You have all of your baby stuff – swaddlers, cloth diapers, breastfeeding pillow, baby carrier, car seat, herbs for postpartum recovery. Getting everything ready for the baby is one of the most exciting parts of pregnancy. But are you ready for the most important part? Are you ready to give birth? Are you ready to take care of yourself and all the other stuff – like your lady parts? Here it is ladies, your perineal care essentials!
Before & After Birth
One of my clients was asked by a friend, “What is the biggest difference in your body before and after birth?” The truth is well said: “I used to have this sweet little pussy. And now I have a crotch, and my crotch needs a lot of care.”
As a midwife, when I ask my clients what their number one fear is about birth, many reply that they are afraid of tearing. Rightly so! But what if you do tear? What happens to your perineum, vagina, and rectum after you push your baby out? How is it going to feel? Will it ever be the same? What should you do to help the tear heal? I'd like to get real with you in this post so that you can be prepared ahead of time to have a more comfortable and joyful postpartum experience.
First and foremost, let me remind you how amazing your body is.
Your pelvic floor and vagina are made to give birth. Even if the muscles stretch and tear, they are woven like a basket to expand, stretch and bounce back. Your brilliant body is great at opening up completely and closing right back again.
Your postpartum recovery process stems from your birth experience, support system, nutrition, and psychological and physical preparedness. Yes, sometimes you may tear and get stitches and you may have a longer recovery than the woman who has an intact perineum. But whether you have stitches or not, you pushed for 4 hours or 20 minutes, you should expect some perineal swelling. Plan for several weeks for a complete recovery.
Having realistic expectations and some basic supplies will help you prepare. Immediately after birth, expect bleeding, abdominal cramps, general perineal soreness and swelling. Your bleeding will be like a heavy period for the first few days and will start to slow down little by little.
Don’t be surprised when you notice several little gushes of blood when you nurse your baby. This is a good thing! Nursing stimulates your uterus to clamp back down to it’s smaller non-pregnant size. When the uterus cramps, it pushes the blood out. The cramps usually resolve in the first few days, but your postpartum bleeding may last up to 6 weeks.
Perineal Care Supplies
You will need a few essential supplies in order to help your recovery go smoothly. The supplies I recommend include:
- disposable underwear
- peri bottle
- herb baths or sitz baths
- Kombu seaweed
- ice packs
- cord care powder
- lube for sex
- fiber to poop
- chucks pads
- overnight pads with wings or cloth pads
All of my private home birth clients order two pairs of disposable underwear and ice packs. Having your complete perineal care kit assembled and ready to go before labor is essential and a huge time saver.
The super cute, one size fits all disposable underwear are nice to have on hand since you will be bleeding for several weeks postpartum, and heavily in the first couple of days. The peri cold packs are intended for the first two-three days after birth when your perineum is the most swollen. It is nice to put the cold pack on after you get out of the herb bath, that way you alternate hot from the bath and the cold from the ice. TRUST me: your lady parts will thank you!
Fill your peri bottle with warm water, such as water from a warm herb bath or with a tea made from cord care powder. Give yourself a gentle squirt while you pee to prevent stinging from the urine touching the tear or stitches. Also, be sure to give yourself a quick rinse after you pee and/or have a bowel movement in order to keep your bottom fresh and clean. Good hygiene is essential to healing.
Herb baths are the fastest, most complete way I know to heal your lady parts. In my practice, a few hours after giving birth the new mom and baby take their “victory bath” filled with healing herbs. These specific herbs are blended together to help reduce bleeding, reduce the swelling, minimize infection, ease the pain and promote tissue elasticity.
You might have stopped on one of the supplies listed above: You want me to put what where? That’s right, ladies! I am suggesting getting Kombu seaweed. In my practice, I joke that I’m a Kombu Convert. There have been several clients whose tears were not bad enough to need stitches, but they needed lots of perineal care. Kombu is like slippery stitches.
Kombu seaweed can be found in Asian markets and health food stores. When you get your Kombu, take out a sheet and cut it to the desired size to fit on your tear. As your getting ready to take your postpartum herb bath, soak the Kombu in a bowl of water for about 30 minutes. Go ahead and get in your bath. After your bath, rinse the Kombu in water a few times to wash off the salt. After soaking for about 30 minutes and at least 3 rinses, it is soft and slick and ready to be placed on your perineum. It should feel cool and soothing.
The Kombu really helps pull the skin together and heals it up nicely. The combination of the herb baths and Kombu works wonders! I would post before and after pictures but, as you might imagine, I did not get permission to do so.
After birth, even the thought of pushing out something else can provoke anxiety in some women. Fortunately, just prior to giving birth your body went through a cleansing process. It may be a day or two before you need to have a bowel movement. In this situation, healthy fibers acting as a stool softener in the form of fruits or herbal supplements are warranted.
You will want to stay extremely hydrated, as well, for several reasons:
- it helps your bowel movements stay soft so you don’t have to push
- it helps dilute your urine so it does not sting,
- and it helps bring your breast milk in.
In my experience, the healing stages of a perineum after birth typically start with a stinging sensation, then a heavy bruised feeling, followed by stitches feeling tight or pulled, and finally the healing itch. Sunlight is an excellent healer. If you have a private space or window, you can allow some sun light to directly shine on your perineum. This feels great in all of the healing stages.
Good muscle tone is essential to your pelvic floor. As soon as you can, start doing kegel exercises a little at a time to build up your pelvic strength and tone. It is super common to have bouts of incontinence after birth. But with time, pelvic rocks, walking, squatting, and kegels you will be able to tighten everything back up right where it needs to be.
Six weeks postpartum, if you have stopped bleeding completely and feel ready for sex, go for it! But take your time, go slow, be gentle, and use lots of good lube. Sex after birth is its own new experience, but one thing I want to mention here is that your body is sending all of it’s available hydration to your milk supply, so your vagina will feel much dryer than it did before giving birth.
As with any healing process, expect that there will be good days and more challenging days. But please remember the more you rest in the beginning, the quicker you will be back on your feet. It’s not being lazy or unproductive if you spend the first few weeks just tending to your baby and your lady parts. That is exactly what you are supposed to be doing now, and it’s REALLY important.