What to Expect

Perineal Incision and Bowel Care

This section covers:  

  • Perineal care  

  • Cesarean Section incision care 

  • Constipation and Hemorrhoids 

  • Intimacy and Sexuality 

 

Whether your baby was born vaginally or by Cesarean, you will bleed from your vagina.  This is part of the healing process for your uterus.  It may continue for 4-6 weeks after you deliver.  In the beginning, it is like a heavy period.  It will be red and may contain small clots.  As you continue to heal, the flow will become less and less.  It may change color to pink, brown, and then white or clear.   

Six weeks after giving birth, your uterus will be back to its normal size.  Normal period may resume.  If your flow has been pink or brown and then turns bright red again, you may have become too active too soon.  Try to decrease your activity level.  Try to increase your rest.  

If you are exclusively breastfeeding, your period may not return while you are breastfeeding.  

 

 

Perineal Care 

  • If you had a vaginal tear, fill the peri-bottle you were given with warm water to rinse front to back every time to go to the bathroom.  Try not to wipe the skin, but pat dry.  

  • Change your pad every time you go to the bathroom.  

  • You may take warm tub baths for 15 to 20 minutes to soak and clean your bottom as needed.  

  • Use Witch Hazel pads or a lidocaine spray to decrease pain.  

  • Do not use tampons until you have stopped bleeding.  This happens around 6 weeks after giving birth.  

  • Avoid sexual intercourse for 6 weeks after delivery or until you stop bleeding.  You can talk to your Provider about birth control.  

  • If you had a tear, the stitches will disappear on their own.  You may feel sore for up to 4 weeks.  You’ll have a postpartum appointment with your Provider around 4-6 weeks after birth.  For more severe tears, your Provider may schedule an appointment 1-2 weeks after birth to check on healing. 

  • After 6 weeks, your normal period may resume.  You may resume using tampons.   

  • Call the Triage nurse if you have any concerns or questions about healing.  

 

Incision Care After a Cesarean Birth 

  • It is normal for the area around your incision to itch, feel numb, or feel like “pins and needles”.  This can last for several months.  

  • The steri-strips (little band-aids) that are on your incision should have fallen off by about 7 days after birth.  If they are still in place after 7 days, try soaking the area with water to help remove them easily.  

  • You may shower daily and gently wash your incision with soap and water.  Pat completely dry.  Do not apply powder or lotions to the incision.  

  • It is important to keep your incision dry.  You may need to wipe it clean and dry it twice a day.  A fan or blow dryer (on cool setting) can help.  You can place dry gauze in skin folds if needed.  

  • Contact the clinic if you have any of the following:  

    • An area of redness that feels warm to the touch or has drainage 

    • Fever 

    • Nausea or Vomiting 

    • Tenderness all over your abdomen 

 

Constipation 

It is normal to have a hard time having a bowel movement after having a baby.  Not moving enough, not eating enough fruits and vegetables, and pain medicine can all cause constipation.  Tips to have a bowel movement easier:  

  • Drink at least 6 – 8 glasses of water a day 

  • Eat a diet with whole grains, and raw fruits and vegetables 

  • Walking 

  • Take a stool softener every morning and night 

 

Hemorrhoids 

Hemorrhoids are inflamed veins around your anus.  If you have hemorrhoids, it may take 2 or 4 weeks for them to get smaller and for you to feel more comfortable.  

To reduce swelling:  

  • Sit with your feet up or lie down whenever you can. 

  • Sit in a shallow bath of cold water. 

  • Apply an ice pack or cold gel pack wrapped in a clean towel for 20 minutes.  

  • Apply a witch hazel pad that has been chilled in the freezer for 10-15 minutes.  

  • Take a stool softener daily to prevent constipation.  

  • Avoid straining with bowel movements.  

 

Intimacy and Sexuality 

You should avoid sexual activity for at least 6 weeks after delivery.  

After having a baby, you and your partner need time to get used to this new life.  You should talk to your partner about what changes need to be made.  Talk about how to meet both your needs and wants.  Be patient with each other during this time of change.  

You should wait 6 months after giving birth vaginally and 12 months after having a Cesarean before getting pregnancy again.  Ask your healthcare provider what birth control might be best for you.  You can still get pregnant while breastfeeding or while not having a regular period.  

These tips may help you when you are ready to resume sexual activity: 

  • Use a water-soluble lubricant such as K-Y Jelly. 

  • Do not use oil-based lubricants such as Vaseline, baby oil, or mineral oil.  

  • If your stitches or a tear make your vagina feel very tender: 

    • Sit in a tub of warm water and gently stretch your vagina with your fingers.  

    • Use a lot of lubricant.  

    • Try positions for sex like side-lying or you on top of your partner to reduce strain on the healing area. 

  • Go slowly.  Talk with your partner about your feelings and concerns.  

  • If you are breastfeeding, it is normal to leak some milk during sexual activity.  It may help to breastfeed your baby before sex.  

Perineal Incision and Bowel Care