What does heavy bleeding after birth feel like with a perineal tear?

A perineal tear can cause pain or stinging between the vagina and anus, especially when sitting, walking, passing urine or opening the bowels. The area may feel swollen, bruised or tender, and a repaired tear may feel tight as it heals. Bleeding after birth comes from the uterus and any vaginal or perineal injury, so the source is not always clear from sensation alone.

Most people with Perineal Tear notice heavy bleeding after birth, but bleeding can also have other causes. A midwife or doctor may inspect the tear, check the stitches and assess how much blood you are losing. Read more about [Heavy Bleeding After Birth](/symptoms/heavy-bleeding-after-birth/).

Use maternity pads and note whether bleeding is becoming heavier, while keeping the perineal area clean and dry according to your discharge advice. Take prescribed pain relief as directed, and ask for help if urinating or bowel movements are very painful. Attend any wound or postnatal review so healing and stitches can be checked.

Contact your maternity team if pain is worsening rather than easing, the wound opens, swelling increases, discharge smells unpleasant, or you develop fever. These changes can signal infection or a wound problem and need examination.

Seek urgent help for rapidly increasing bleeding, faintness, severe weakness, a racing heartbeat, severe perineal pain, inability to pass urine, or a large swelling that is getting worse. Call emergency services if you collapse or have difficulty breathing. Do not wait for a routine postnatal appointment when bleeding is heavy or you feel unwell.

How deep is the tear and are the stitches healing as expected? Which pain and bowel-care measures are suitable? What bleeding pattern is expected for me? Which changes mean I should return urgently?