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Post-birth perineal and tailbone pain refers to the discomfort experienced in the pelvic floor, anal area, or coccyx after vaginal delivery. It often stems from vaginal tearing, prolonged labour, instrument-assisted delivery, or simply the pressure of the baby’s descent.
How It Affects Your Recovery and Daily Life
Pain in these areas can impact and interfere with:- Sitting and breastfeeding your baby comfortably: Even short periods of sitting can feel unbearable, making feeding sessions stressful.
- Walking, standing, or transitioning between movements: Even shifting weight while getting out of bed may cause a wince.
- Using the toilet or passing stool without fear: Straining with constipation can trigger stabbing perineal pain or reopen stitches.
- Resuming intimacy or pelvic physiotherapy: Touch, insertion, or even stretching can cause flashbacks of birth pain or injury.
- Sleep, posture, and mental well-being due to chronic discomfort: You may dread simple movements and feel isolated or unsupported.
What Causes This Pain?
Multiple factors affect the intensity, location, and extent of this pain.- Perineal tears or episiotomy: These surgical cuts or natural tears can leave the area swollen, bruised, or stitched. Healing can be itchy, tight, or painful.
- Tailbone trauma or bruising: The coccyx can be compressed, misaligned, or bruised during labour, especially in long pushing phases or when forceps are used.
- Nerve compression: The pelvic nerves may become irritated or inflamed due to prolonged pressure or the use of delivery instruments, such as forceps or vacuum.
- Haematomas: Internal bleeding near the perineum can create painful swelling that makes sitting difficult and may require medical drainage.
How It’s Diagnosed or Assessed
Diagnosis is largely clinical. Your doctor will:- Examine the perineal stitches or tissue
- Palpate the tailbone for tenderness, misalignment, or swelling
- Ask about pain while sitting, walking, or passing stool
- Rule out infection, wound breakdown, or pelvic haematomas
Treatment and Management Options
This constant pain can be the source of emotional exhaustion as well.- Warm sitz baths: Sitting in a shallow bath of lukewarm water helps reduce swelling, improve blood flow, and soothe stitches or bruising.
- Cushions or doughnut pillows: These help redistribute pressure when sitting, preventing direct compression on the coccyx or perineum.
- Pelvic floor physiotherapy: A trained therapist can guide you through gentle release techniques, alignment corrections, and perineal massage to reduce scar stiffness and nerve entrapment.
- Topical anaesthetics or pain relievers: Lidocaine gels or prescription creams may ease local pain. Over-the-counter painkillers like paracetamol may be used if breastfeeding-safe.
- Stool softeners and hydration: Prevent straining and tearing by softening stools. Psyllium husk, prunes, and plenty of water can help.
- Avoid sitting or squatting for long periods: Especially during the first two weeks postpartum. Switch positions often and lie on your side if possible.
Emotional and Practical Support
Pain in your most intimate areas can feel embarrassing or even shameful, but it shouldn’t. Tailbone and perineal pain is deeply physical and deserves care like any other injury.- Don’t hesitate to ask your doctor for a pain assessment if your discomfort interferes with daily life.
- Ask family members or your partner to help with baby-related tasks that involve bending, lifting, or sitting for long stretches.
- If postpartum mental health feels affected, especially if pain makes you dread feeding, movement, or recovery, speak to a therapist or postpartum doula.
- Give yourself permission to heal on your own timeline. You are not expected to “bounce back.”
FAQs on Tailbone and Perineal Pain Post-Birth
- How long does tailbone or perineal pain last after delivery?
Most pain improves within 2–6 weeks, depending on whether there were tears, stitches, or bruising. Persistent pain beyond 8 weeks may need physiotherapy or imaging. - Is this pain normal after a vaginal birth?
Yes. It’s very common, especially with episiotomy, forceps use, or prolonged labour. However, severe or worsening pain should always be reviewed. - Can I use pain relief medication while breastfeeding?
Paracetamol and ibuprofen are considered safe for most breastfeeding parents. Avoid aspirin unless specifically advised by your doctor. - Will I need physiotherapy?
Not always, but if your pain prevents walking, feeding, or recovery, a pelvic health physiotherapist can help reduce symptoms and retrain muscles safely.