Care of your perineum following 1st and 2nd degree tears.You can learn more about how we ensure our content is accurate and current by reading our editorial policy. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Birthing your baby while squatting or standing may be safe options to discuss with your doctor or midwife. Lying flat on your back during pushing may put you at an increased risk of tearing due to the angle. Consider asking about this during your prenatal visits. Your doctor or midwife may also perform a massage (with gloves) during the pushing stage. Either you or your partner can insert two lubricated fingers into the vagina and move them side to side using some gentle pressure toward the rectum. You can start perineal massage late in your third trimester to prepare the vaginal tissues for stretching. Try applying a warm washcloth to your perineum as you get closer to the pushing stage. Keeping the perineum warm may also help those tissues stretch. While difficult, taking your time will give your vaginal tissues some added time to stretch and accommodate your baby’s head and body. In the second stage of labor (the pushing stage), speak with your doctor or midwife about pushing slowly and gently. That said, first-time pregnancy is a risk factor for tearing, so you may not be as likely to tear in subsequent pregnancies. A lot of it has to do with factors that are outside of your control, like the size of your baby’s head or their presentation in the birth canal. Tears during delivery are common, so you may not always be able to prevent them from recurring in future pregnancies. Is it possible to prevent tearing in future vaginal births? When you do get a few minutes to lie down, try elevating your hips using a pillow. This is hard to do with a newborn, but it’s important for the healing process. Otherwise, be sure to rest as much as you can. When you feel ready (as soon as 2 to 3 days after delivery), be sure to do regular Kegel exercises to strengthen your pelvic floor muscles. Be sure to opt for foods that are rich in fiber, such as fresh fruits and vegetables, over cereal, whole grain breads, and pastas. Still, it’s necessary to avoid constipation, which could be a whole lot more painful. If you’re worried about pooping with your stitches, that’s completely understandable. Aim for six to eight glasses each day to help keep your bowel movements regular and soft. Timing showers and bathing after bowel movements gives you an opportunity to wash away anything you missed that might infect your stitches. While traditionally used to help treat hemorrhoids, they may help relieve burning and itching around your stitches. Consider layering your pads with Tucks medicated cooling pads or similar ones containing witch hazel. This will help keep the area clean and dry and ward off bacteria. You fill the bottle with lukewarm water and point the stream at your perineum as you urinate to eliminate stinging. Your hospital may even give you this postpartum essential as a parting gift before you return home. Icing is particularly helpful the first day or two after delivery. Instead, wrap the ice pack in a light towel, and apply it for 10-to-20-minute increments for a total cooling session of 1 to 2 hours. That said, don’t apply ice directly to your perineum. You might consider applying an ice pack to the affected area for pain relief.
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