Something that everyone will have to do postpartum, regardless of the birth they have, is perineal care. This covers not just taking care of the sore perineum, but also managing the vaginal bleeding. For those who had a vaginal birth, or those who had a c-section after laboring, the perineum will be sore so the gentle options of perineal care are more preferred. For those who had a c-section without laboring, the perineum may not be as sore, but perineal care is still important for hygiene!
Keep the Perineal Area Clean and Dry
Keeping the vagina, rectum, and perineal area clean after having a baby can be helpful to reduce risks of infection, but also for overall comfort. If there are any lacerations, abrasions, or an episiotomy was done. This is a wound that needs to heal, so we want to keep bacteria away to avoid infections. Also, after having a baby, the wound in the uterus where the placenta was attached has to heal. This leads to vaginal bleeding for 4-10 weeks in most as the wound goes through the healing process. This can lead to the perineal area being wet for a long period of time, and if not cleaned often can lead to discomfort. I would notice when I waited too long to change my pads, I would have more vaginal itching and discomfort.
Perineal Care is recommended every 1-4 hours depending on the person. Usually when you one feels the urge to go to the bathroom is how often we should change the pads and clean the bottom with water and maybe even use perineal healing sprays/ointments.
What do we need for perineal care?
At a minimum we need:
- pads
- comfortable underwear
- a Peri bottle
Some prefer to use the adult diaper version, where its underwear and a pad all in one versus the mesh underwear and big pad.
It can be less clean up, and oftentimes more comfortable. They are especially helpful for nighttime, and the first week when bleeding is heavier. When bleeding has slowed down then many switches to their usual underwear and maxi-pads.
Some companies have created underwear specifically for postpartum, like bodily(link). They’re higher waisted, soft fabric, and stretchy.
The peri bottle given at the hospital and some birth centers is just fine to use, filling it up with warm water and then spraying the perineal to gently rise off the blood to avoid or minimize having to wipe the perineal area. Toilet paper is not super soft or strong sometimes, so using toilet paper could lead to more irritation of the perineum and leave small pieces of toilet paper behind. Some find using herbal tea in their peri-bottle to be more soothing on the bottom, especially after vaginal birth or a labored c-section.
There are other options for peri bottles such as the Frida mom or Bao Bei has one as well where they are easier to use. You don’t have to contort your body to be able to get the water onto your perineum.
Some bonus items to use for perineal care can be ice packs, especially for the first 24-48 hours where the swelling is the worst. You can even make padsicles, which are frozen maxi pads with witch hazel & aloe that you can make before birth that are very soothing postpartum. Perineal sprays/ointment to help with healing of any wounds on the perineum. I got one from my birth center that was AMAZING! It also smelled nice, because postpartum discharge does not smell great as the placenta wound heals. Witch hazel/Tucks pads are great for swelling and hemorrhoid treatment!
I would put all of these items in a basket to leave in all the bathrooms you will use regularly postpartum. It made it super easy to be able to do my peri care postpartum and not have to scream from a bathroom for help. I also had a basket at my bedside of pads for the bed along with extra maxi pads and underwear just in case i leaked through my pad, the pad on my bed saved my sheets and mattress.
Once we started leaving the house, I would have a travel toiletries bag that had an extra pair of underwear, pads, a peri bottle, and some sort of perineal spray for peri care on the go. Most of the time I would also pack a water bottle to fill the peri bottle up with water because I usually don’t have access to a sink when in a public restroom.
The need for peri care lasts until vaginal bleeding stops! So, this could last 4-10 weeks! You may not be wearing the full-blown diaper for the whole time, but most of us only have a period for around 5 days so to have to wear a pad for longer can be an adjustment. Especially when we didn’t have a period for the past 10 months!