Postpartum perineal care - Advice on perineum repair and re-education
It's important to be very careful about your recovery after giving birth. You may have experienced tearing and had an episiotomy or some form of perineum repair. Here are some tips on caring for the area and getting it back into shape postpartum.
Perineum repair is done surgically after delivery and normally occurs if there was a tear during labour or if an episiotomy was performed. Even if this didn’t happen to you, perineal pain is a common after effect of a vaginal delivery. Postpartum care of this area is essential to help speed up the healing process and prevent infection or future health problems.
RELATED: What exactly is an episiotomy?
Perineum repair: What to do right after delivery
For the first few weeks after delivery, you may experience perineal pain, especially if you have stitches. A good personal hygiene routine and a few simple remedies can really help relieve the soreness you will feel in that area. Try these tips:
- Wash with warm water after each toilet use. Make sure that your hands are clean when changing your pad.
- Use an ice pack if you feel a lot of discomfort. An antiseptic spray can also be very useful for bigger wounds.
- Make sure you eat enough fibre to avoid constipation.
Perineum repair: Perineal re-education
Perineal re-education refers to the strengthening of the perineum and pelvic floor muscles. This is important for all new mums whether they had a vaginal birth or not. The pregnancy weight is enough to weaken those muscles.
During your post-natal appointments, the doctor should let you know if your perineum has healed properly. Normally, you need to wait around eight weeks before starting perineal re-education. The area needs to be totally healed and any bleeding should have stopped.
Methods that help perineum repair and re-education
- Speak to a kinesitherapist, a specialist in pelvic floor re-education techniques. Basically a physiotherapist for your perineum, this person will assess how well you can control these muscles and then recommend which method is best to build strength.
- Electrical stimulation can help during the exercises to stimulate the muscles by creating contractions.
- Use perineal bio-feedback to assess how much control you have over the perineum.
- To those who want to do abdominal re-education to shed the baby weight, do a perineal re-education first. Abdominal training can put an extra strain on the perineum. Wait at least three months after birth to do any fitness routine.
- All new mums should practice pelvic floor exercises, or Kegel exercises, before and after birth to help with perineum re-education and keep the muscles in good shape. Any mum can do these almost anywhere! Contract the muscles as if you were trying not to go to the toilet and hold for 10 seconds before releasing. Repeat this 10 times, 3 times a day.
Watch how and when to do those important pelvic floor muscles, before and after pregnancy.
Perineum repair: Benefits of perineal re-education
There are many reasons for being very careful about perineum repair after giving birth. Following re-education techniques helps to:
- Return your pelvic muscles to their pre-pregnancy state;
- Prevent urinary incontinence, a common and unpleasant condition that affects many women who have given birth;
- Prevent uterine and vaginal prolapse, a condition that requires surgery; and
- Improve sexual intercourse and prevent pain during sex.
Can you prevent a tear from happening before giving birth?
During pregnancy, every woman should follow a few simple steps to prepare the perineum for birth. Doing these can prevent the need for an episiotomy and tearing during delivery:
- Kegel exercises for strengthening the pelvic floor muscles;
- Applying natural creams for perineum massage. When done daily a few months before giving birth, it helps the tissue become more flexible which really helps during delivery;
- Ask your doctor regarding special devices that can strengthen the perineum. There are devices that can be used daily by pregnant women.
It’s important to help your muscles strengthen again after delivery. Following these guidelines will help with any pain you feel in that area and will also prepare your body in advance for any future pregnancy.