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Perineal Tear: What to Expect at Home

Your Recovery

A perineal tear can happen when you deliver your baby. It is a tear to your perineum (say "pair-uh-NEE-um"), which is the area between your vagina and anus.

After delivery, the doctor or midwife usually closes the perineal tear with stitches. The stitches will dissolve in 1 to 2 weeks, so they will not need to be removed. You may notice pieces of the stitches on your sanitary pad or on the toilet paper when you go to the washroom. This is normal.

Sometimes, a small tear won't be closed with stitches and will be allowed to heal on its own.

You may place an ice pack against your perineum to ease pain and swelling.

Recovery can be uncomfortable or painful, depending on how deep and long the tear is. It's most painful at the beginning, but you should feel better each day. Pain typically affects sitting, walking, urinating, and bowel movements for at least a week. Your first bowel movement may be painful. A tear is usually healed in about 4 to 6 weeks.

This care sheet gives you a general idea about how long it will take for you to recover. But each woman recovers at a different pace. Follow the steps below to feel better as quickly as possible.

How can you care for yourself at home?

Activity

Rest when you feel tired. Getting enough sleep will help you recover.
Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor or midwife says it is okay.
Until your doctor or midwife says it is okay, do not lift anything heavier than your baby.
Ask your doctor or midwife when you can drive again.
You may shower and take baths as usual. Pat the incision dry when you are done.
You will have some vaginal bleeding. Wear sanitary pads. Do not douche or use tampons until your doctor or midwife says it is okay.
Ask your doctor or midwife when it is okay for you to have sex.

Diet

You can eat your normal diet.
Drink plenty of fluids (unless your doctor tells you not to).
You may notice that your bowel movements are not regular right after your delivery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fibre supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor or midwife about taking a mild laxative.

Medicines

Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
If you have pain, take pain medicines exactly as directed.
- If the doctor gave you a prescription medicine for pain, take it as prescribed.
- If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
If you think your pain medicine is making you sick to your stomach:
- Take your medicine after meals (unless your doctor has told you not to).
- Ask your doctor for a different pain medicine.

Wound care

Put ice or a cold pack on the sore area for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.
Sit in 8 to 10 centimetres of warm water (sitz bath) for 15 to 20 minutes 3 times a day and after bowel movements. Then pat the area dry. Do this as long as you have pain. You may find that it feels better if you dry the area with a hair dryer instead of using a towel to pat the area dry.
Keep the area clean by pouring or spraying warm water over the area outside your vagina and anus after you use the toilet. Use baby wipes or medicated pads, such as Tucks, instead of toilet paper after a bowel movement.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Share this information with your partner, family, or a friend. They can help you watch for warning signs.

Call 911 anytime you think you may need emergency care. For example, call if:

You feel you cannot stop from hurting yourself, your baby, or someone else.
You passed out (lost consciousness).
You have chest pain, are short of breath, or cough up blood.
You have a seizure.

Call your doctor, midwife, or nurse advice line now or seek immediate medical care if:

You have signs of hemorrhage (too much bleeding), such as:
- Heavy vaginal bleeding. This means that you are soaking through one or more pads in an hour. Or you pass blood clots bigger than an egg.
- Feeling dizzy or light-headed, or you feel like you may faint.
- Feeling so tired or weak that you cannot do your usual activities.
- A fast or irregular heartbeat.
- New or worse belly pain.
You have symptoms of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the wound.
- Pus draining from the wound.
- A fever.
- Vaginal discharge that smells bad.
- New or worse belly pain.
You have symptoms of a blood clot in your leg (called a deep vein thrombosis), such as:
- Pain in your calf, back of the knee, thigh, or groin.
- Redness and swelling in your leg or groin.
You have signs of preeclampsia, such as:
- Sudden swelling of your face, hands, or feet.
- New vision problems (such as dimness, blurring, or seeing spots).
- A severe headache.

Watch closely for changes in your health, and be sure to contact your doctor, midwife, or nurse advice line if:

Your vaginal bleeding isn't decreasing.
You feel sad, anxious, or hopeless for more than a few days.
You are having problems with your breasts or breastfeeding.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

Enter D248 in the search box to learn more about "Perineal Tear: What to Expect at Home".

Adapted with permission from copyrighted materials from Healthwise, Incorporated (Healthwise). This information does not replace the advice of a doctor. Healthwise disclaims any warranty and is not responsible or liable for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.