Perineal tear not healing: what to know

A wound may heal slowly when its edges have separated, bacteria are present, moisture and friction keep irritating it, or the original injury was deeper than first recognised. Ongoing constipation and straining can add pressure. Persistent soreness can also come from granulation tissue or a dermatological condition rather than infection. Examination is needed to distinguish these possibilities and decide whether the wound should be treated, repaired, or allowed to heal with monitored care.

Book a review with your maternity, gynaecology, or primary-care team, particularly if symptoms are worsening. Keep the area gently clean and dry, change pads regularly, and avoid sex, tampons, swimming, or strenuous movement if these increase discomfort. Prevent straining with fluids, fibre, and a bowel plan recommended for you. Do not pick at stitches or use unprescribed creams. A clinician may refer you for Perineal Repair or later Postnatal Physiotherapy depending on the finding.

Seek same-day medical advice for increasing pain, redness, swelling, discharge, foul smell, bleeding that returns, or a wound that is opening. Get urgent help for fever with feeling unwell, heavy bleeding, faintness, severe pain, or inability to pass urine. New loss of bowel or wind control should be reported promptly, especially after a deeper birth injury.

Ask whether the wound is infected or separated, whether any stitches remain, and whether a swab or other examination is needed. Ask what activities are safe, how to manage bowel movements, which pain relief fits your situation, and what follow-up will check that healing is progressing.