Before and after a perineal tear

Recovery focuses on keeping the area clean, controlling pain, avoiding constipation and strain, and watching for infection or problems with bladder or bowel control. A deeper tear can involve the muscles around the anus and needs specific repair and follow-up.

The perineum is the tissue between the vaginal opening and anus. A clinician examines the vagina, perineum, and anal sphincter after birth to establish which tissues are affected. Some small tears heal without stitches; tears involving muscle generally require repair with dissolvable sutures and suitable pain relief or anaesthesia.

Soreness, swelling, bruising, and stinging when passing urine can occur during early healing. Bowel movements may feel worrying, but delaying them can make stools harder. Persistent loss of wind or stool, urgency, painful sex, or a feeling of vaginal heaviness deserves assessment rather than being accepted as an unavoidable result of childbirth.

Wash your hands before and after changing pads, rinse the area gently with water, and pat dry from front to back. Change maternity pads regularly and avoid scented products on healing tissue. Take prescribed pain relief, antibiotics, or stool-softening medicine as directed, and drink enough fluid to keep urine pale unless you have been told to restrict fluids.

Rest in positions that reduce pressure, but include gentle movement as comfort allows. Begin pelvic-floor contractions only when your maternity team says they are suitable; they should not cause sharp pain. Wait for clinical advice before inserting tampons, resuming penetrative sex, or undertaking high-impact activity. Lubricant may improve comfort when sex resumes after healing.

Contact your maternity team promptly if pain, swelling, or redness is worsening; the wound opens; discharge smells unpleasant; pus appears; or you develop fever or feel increasingly unwell. Urgent assessment is needed for heavy bleeding, fainting, inability to pass urine, severe rapidly increasing pain, or new loss of bowel control. Painful calf swelling, chest pain, or sudden breathlessness requires emergency care.

Ask which tissues were affected, how the tear was repaired, whether you need antibiotics or stool softeners, and when the stitches should dissolve. Discuss any trouble controlling wind, stool, or urine, as well as pelvic pressure or ongoing pain. Request clear guidance on driving, exercise, sex, future birth planning, perineal repair review, and referral for postnatal physiotherapy.