In this article:
What Happens to the Perineum After Birth
After a vaginal birth, the perineum goes through a series of healing stages.1. Swelling and tenderness (first few days): Fluid and blood flow to the injured area increase. It feels bruised, sore, and sometimes warm to the touch.
2. Scab formation and tissue repair (days 4–10): If you have stitches, the sutures hold the tissue together as collagen rebuilds underneath. You might notice mild itching or tightness as the wound knits.
3. Gradual recovery (weeks 2–6): Swelling subsides, stitches dissolve, and pain improves. You should be able to sit comfortably and resume gentle movement by the end of this period.
During this time, mild discomfort, itching, or pulling are expected, but pain that worsens, throbs, or smells foul is not.
Normal Healing Sensations vs. Warning Signs
Below is a simple comparison to help you identify when pain is within the normal range and when it may indicate an infection or another complication.| Normal Healing | Possible Infection or Concern |
| Dull soreness, especially when sitting or walking | Sharp, increasing pain after initial improvement |
| Mild swelling and tenderness | Significant swelling or redness spreading outward |
| Clear or light yellow discharge from stitches | Foul-smelling, greenish, or bloody discharge |
| Mild itching as skin heals | Persistent burning, especially with fever or chills |
| Occasional discomfort during urination | Stinging, difficulty passing urine, or needing to urinate often |
| Gradual pain reduction by week 2–3 | Pain persists or worsens beyond 2 weeks |
If you notice the right-hand symptoms, it’s best to contact your doctor or midwife promptly.
Common Causes of Perineal Pain
Pain after delivery doesn’t always mean infection. It can come from several sources:- Bruising: Pressure during childbirth can bruise the perineal muscles even without tearing.
- Tears or episiotomy: Deeper stitches naturally cause more pain during recovery.
- Haematoma: Rarely, internal bleeding creates a firm, painful lump.
- Infection: Bacteria entering the wound cause redness, pus, and fever.
- Nerve sensitivity: Some women experience nerve-related tingling or burning as tissue regenerates.
Who Is More at Risk for Perineal Infection
Certain factors make postpartum women more prone to perineal wound infections:- Prolonged labour or instrumental delivery (forceps or vacuum).
- Episiotomy or deep second-degree tear.
- Gestational diabetes or obesity can delay healing.
- Poor perineal hygiene or moist environments.
- Anaemia or low immunity post-delivery.
- Cultural practices restricting bathing or air exposure during confinement.
When It’s More Than Just Pain: Recognising Infection
A perineal wound infection typically develops between 3–10 days after birth. Watch out for:- Increasing pain instead of gradual improvement.
- Swelling or redness spreading beyond the stitches.
- Discharge with odour or pus at the wound site.
- Fever (≥38°C), chills, or body ache.
- Painful urination or difficulty moving your bowels.
How Doctors Diagnose and Treat Perineal Infections
Your doctor will examine the area and may gently separate the stitches to assess healing. Swabs of discharge might be taken for bacterial culture.Treatment typically involves:
- Antibiotics: Safe for breastfeeding (often amoxicillin-clavulanate or cephalexin).
- Pain relief: Paracetamol or ibuprofen as prescribed.
- Wound care: Cleaning with saline, keeping the area dry, and allowing air circulation.
- Sitz baths: Warm water soaks 2–3 times daily for 10–15 minutes reduce pain and swelling.
Supporting Healing at Home
While medication helps, daily care is crucial for recovery:1. Maintain hygiene: Wash your hands before and after touching the area. Change maternity pads frequently.
2. Use warm compresses or sitz baths: Warmth increases blood flow and eases soreness. Avoid harsh antiseptics unless prescribed.
3. Stay dry: Pat gently after bathing; avoid tight clothing or synthetic underwear.
4. Eat nutrient-rich foods: Iron, vitamin C, and protein help collagen repair. Hydration supports wound healing.
5. Move gently: Short walks improve circulation and prevent constipation, which can strain stitches.
6. Avoid self-applying herbal pastes or powders: Some traditional remedies can trap bacteria or delay healing; check with your doctor before use.
Ayurvedic and Natural Recovery Aids
Ayurveda views postpartum perineal pain as a Vata imbalance linked to dryness, wind, and weakness. Traditional care focuses on warmth, oiling, and nourishment:- Warm sesame oil application (after full healing and doctor clearance) to soften tissues.
- Dashamoola or Shatavari decoctions under supervision for internal healing.
- Abhyanga massage for improving blood circulation.
When to Seek Urgent Care
You should contact your doctor immediately if you experience:- Severe or spreading pain despite medication.
- Foul smell, pus, or excessive bleeding from the wound.
- Fever, dizziness, or chills.
- Pain is making it impossible to sit, feed, or move.
- Difficulty controlling urine or stool (may indicate muscle injury).
Perineal soreness is a natural part of recovery after childbirth, but pain that worsens, smells, or comes with fever isn’t normal. Your comfort and health matter. Don’t hesitate to get checked. With prompt care, simple hygiene, and balanced rest, healing can be complete, comfortable, and free from complications.
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FAQs on Sore After Giving Birth? What to Know About Perineal and Pelvic Pain
- How long should perineal pain last after childbirth?
Most soreness improves within 2–3 weeks. Deep tears may take up to 6 weeks to feel normal. Persistent pain beyond that should be assessed. - Can I use antiseptic solutions like Dettol or Betadine?
Not routinely. They can irritate healing skin. Use warm water or mild saline as advised. - Is pain normal during sex after a tear or episiotomy?
Mild discomfort the first few times is common, but sharp or persistent pain may suggest tight scar tissue or dryness. Pelvic physiotherapy helps. - Does sitting cross-legged delay healing?
It may put pressure on stitches initially. Use soft cushions and change positions often until pain subsides.
