HealthInfo Waitaha Canterbury
Self-care after a perineal tear
Tāu ake whakaora i muri i te tīhaenga ā-tero
Use ice packs for the first 24 hours to help reduce your pain and swelling. Hold ice wrapped in a cloth to your wound for 20 minutes every 4 or 5 hours.
Keep your perineal area clean and dry. You should shower and bath as usual and dry the area by gentle patting with a clean towel or disposable cloth.
After passing urine (peeing) or a bowel motion (pooing), it is important to clean the area with a cloth and pat it dry, rather than wipe.
Make sure you change your pads and wash your hands regularly to reduce the risk of infection.
Avoid constipation following your tear
If you are breastfeeding, aim to drink 2.5 to 3 litres (9 to 10 cups) of fluid every day. Otherwise, aim for 2 litres (8 cups). This includes fluids such as soup, milk and hot drinks, but try to make at least half of your drinks water.
Try not to skip meals and include plenty of fibre in what you eat. Choose a high-fibre breakfast cereal or wholegrain bread for breakfast. Have 2 or more pieces of fruit a day and have vegetables with dinner and lunch if possible. Also try to choose snacks such as wholegrain crackers, a bran muffin, fruit or popcorn.
It is also important to sit properly when pooing (passing a bowel motion) as this means you do not need to strain as much. Try to:
- have your knees higher than your hips, either raising your heels or using a low 15 cm footstool
- lean forwards from your hips, keeping your lower back curved (like in the picture)
- keep your knees apart, and rest your forearms on your knees
- make your waist wide and gently bulge your tummy forward as you work with the urge to go. Do not strain.
You can support the area with stitches by holding a wad of toilet paper to it. And when you have finished, lift your pelvic floor muscles a few times.
Exercise and posture
Your pelvic floor muscles run from your pubic bone at the front of your pelvis to your tail bone at the back. They help to control your bladder and bowel and support your pelvic organs. Pregnancy often makes these muscles weak, and the tear will have injured them.
Start exercising your pelvic floor muscles as soon as you can. Exercising them early on will help reduce your pain and swelling and help you to heal.
There are several other things you can do to help your healing.
- Avoid sitting and standing for long periods, especially in the first few days. Lying on your side is a good position to rest in.
- Avoid lifting anything heavier than your baby for at least the first 2 weeks.
- Return to low-impact exercise gradually.
- Avoid any exercise or activity that involves jarring, jumping or straining for at least 6 weeks.
Physiotherapists recommend low-impact exercise and no running for at least 3 to 6 months and sometimes longer after having a third- or fourth-degree tear.
If you need any further advice or help with your pelvic floor exercises, ask your midwife or LMC to refer you a physiotherapist.
Getting help
While you recover, you may have some mild pain or soreness in your perineum.
Tell your midwife, LMC or general practice team if:
- your stitches become more painful or smell bad
- you feel a need to rush to the toilet or cannot control your bowel, bladder or wind (farting)
- your perineum is still sore or tender after the stitches have dissolved.
If you are having difficulty with bladder or bowel control or restarting sexual intercourse, ask your midwife or LMC to refer you to a physiotherapist.
HealthInfo recommends the following pages
- Te Whatu Ora Waitaha – Third or fourth degree perineal tear
This factsheet has information about third- and fourth-degree perineal tears. It includes how they are repaired and follow-up treatment.
Written by Physiotherapy Services and Maternity Services, Christchurch Women's Hospital. Adapted by HealthInfo clinical advisers. Last reviewed November 2024.
SourcesReview key: HIGIB-113323
