First off congratulations on your new baby! It can be difficult to get the rest you need to heal with a new baby in the house. It is recommended that you spend as much time in bed the first two weeks of healing. Please allow friends and loved ones to help you during this time. Remember that taking the time to heal early will pay off and the faster you are healed, the faster you can do all the activities you want to enjoy with your baby. This said, the first six weeks are important for muscle and soft tissue recovery. Everyone heals at a different rate and you have sustained a severe injury, so do not be discouraged if you do not feel back to baseline by 6 weeks. Please see our resources section for products that women have found helpful in their recoveries. This information is not certified medical advice and should not substitute the instructions given to you by your healthcare provider.
Tips for pain relief brought to you:
- Alternate Tylenol and Ibuprofen every 4-6 hours, try to avoid opioid pain medications as these can cause constipation. Do not take more than 4,000 mg or 4 grams of Tylenol in 24 hours and do not take more than 2,400 mg a day.
- Lie down as much as possible, especially the first few days as this will reduce swelling and discomfort. Try to lie down at least an hour each morning and afternoon the first weeks after your injury.
- Ice can be a great help and can reduce swelling as well as pain. Use a premade ice pad or place an ice pack inside your pad for 20-30 minutes at a time. Do not let the ice pack have direct contact with your skin. You can repeat this every 2-3 hours while awake.
- Supportive underwear such as shapewear will also reduce swelling and support the area.
Ensure proper hygiene and moisture control in the affected area to promote healing. This can be achieved in part by wearing cotton underwear and loose fitting airy clothing. If you are able to lay down on a towel to leave your laceration open to the air, this will also aid in moisture control especially after sitz baths. Keeping the vaginal and anal area clean can be challenging but is crucial for recovery. Use fragrance-free wet wipes, sitz baths, showers, upside down peri bottles, or any convenient method to maintain cleanliness. Warm water is advised for both the sitz baths and the peri bottle. Sitz baths should be performed for 10-15 minutes approximately 3 times a day. Avoid dragging dry paper, like toilet tissue, over the area. Instead, use moistened paper to minimize friction and prevent stitches from being pulled. Some women like using witch hazel pads instead of toilet paper during recovery.
Nutrition / Bowel Function
In the case of a third or fourth degree tear, it may be necessary to follow a low-fiber or low residue eating plan for the initial seven to ten days. This approach helps minimize bowel movement frequency and lessens pressure on the affected region. To prevent constipation during the healing process, a mild laxative such as Miralx will be incorporated into the dietary regimen. Some women also find a tablespoon of mineral oil mixed with orange juice in the morning helpful to help bowel movements pass smoothly. Once the ten-day period has passed, a gradual transition to a high-fiber diet is recommended to restore normal bowel function. Also ensure that you stay well hydrated and drink at least 16 cups of water a day, this is especially important if you are breastfeeding. Try to take a few short walks daily to help keep your bowels moving. Do not ignore the urge to go to the restroom and take your time. You may find that a squatty potty can help place your body into a position to optimize the passage of stool, see below for imaging of proper body position for bowel movements. Also, try not to strain but instead take a deep breath in and exhale slowly. It is also helpful to support your perineum while having a bowel movement, panty liners can be used for this. Make sure you clean well after a bowel movement. Upside down peri bottles, wet wipes, or a handheld shower head can be helpful with this. Always make sure to gently dab or wipe front to back.
Activity Modifications While Healing
Everyone's circumstances and healing journeys are different so this is just an approximate timeline.
- Avoid lifting anything heavier than your baby for 6 weeks.
- Try to rest as much as possible for the first 2 weeks.
- Driving may be resumed at 2 weeks postpartum but should not be resumed if you are still taking opioid pain medication.
- Light cleaning such as dusting and cooking can be resumed at 3 weeks postpartum.
- You may resume short walks at 3 weeks postpartum.
- Vacuuming and more strenuous household cleaning may be resumed at 7-8 weeks postpartum.
- Avoid strenuous exercise that puts pressure on the perineum or pelvic floor for at least 6 weeks. You have sustained a severe tear so slowly ease back into your exercise routine. It is not uncommon for healing to take 6 months or longer after a severe tear. You will want to start back to exercising with core and pelvic floor workouts. A PFPT can help you with this.
- You may be medically cleared for sexual activity at 6 weeks postpartum but you may not feel physically or mentally ready by that point and that is perfectly normal. Please see our Sex Section below for more advice.
- You may also be cleared for high impact exercises such as running at 6 weeks postpartum, however, it may be better to resume these activities slowly and strengthen your core and pelvic floor first. Returning to these activities at 12 weeks may be more comfortable. If you are participating in PFPT, ask your therapist if you are ready to resume these activities first.
- Return work at 12 weeks postpartum. Some women do not feel comfortable returning to an in person work setting, please see our employment support section for help.
You should not engage in sexual activity until you have been cleared by your healthcare provider. Even though you may have received clearance, it does not mean that you are emotionally or physically ready to do so. Discuss your worries openly with your partner and do not feel guilty about taking your time to resume sexual activity. There are other things you can do together that do not involve penetrative sex and still allow you to feel close to your partner. You and your body have been through a lot so do not rush things. It will be more pleasurable for both of you if you are ready. It may take several attempts to feel comfortable so take things slow. Also, you may require lubrication, especially if breastfeeding. Natural lubricants last longer and are less irritating to the vagina and vulvar area.
Selfcare Through Mental Health
Experiencing a tear during childbirth can have a profound impact on your emotions and mental well-being. It is a traumatic event, and disregarding your experiences and concerns will not benefit you. It is important to acknowledge and address your feelings. Although it may feel embarrassing to discuss the affected area with friends, relatives, or your partner, opening up about your journey can bring tremendous relief. You are not alone in this experience, as countless women worldwide understand what you are going through and would welcome the opportunity to connect. Please join us for our free support groups, more information can be found on these and other support resources in our support section.
It is common to feel isolated during this time, as the focus often shifts to the joy of having a new baby, leaving behind the pain and emotional distress caused by a difficult tear. However, maintaining the joy of motherhood involves seeking help when needed and prioritizing your mental health as much as your physical well-being. Many women have found professional mental health support to be beneficial, particularly therapies that address trauma, such as Cognitive Behavioral Therapy (CBT) or Eye Movement Desensitization and Reprocessing (EMDR). If you are struggling, it is important to reach out to a mental health professional for assistance. Please see our provider resource section to connect with mental health providers that specialize in child birth trauma.