What you can do If you had an episiotomy, your incision should take about 10 days to heal; discomfort from a stitched perineal tear can take up to six weeks to abate, especially if it was a jagged tear. What can you do to ease the discomfort? “Take sitz baths—sit in a few inches of warm water—for a couple of minutes several times a day,” Phelan says. Don’t soak for more than a few minutes at a time, or you’ll risk introducing infection. And don’t use soap or bubble bath, as both can be irritating. Also helpful: Use a squirt bottle to rinse your bottom with warm water after you urinate; use ice packs; and, if sitting is very painful, use an inflatable “donut” or horseshoe-shaped nursing pillow to take pressure off your bottom.
Some women also say that soaking cotton balls in witch hazel and placing them on the perineum for a few minutes helps ease discomfort, as does using a Xylocaine spray (although some doctors don’t favor such sprays because of the risk of allergic reaction).
Constipation is particularly common among women who have had a Cesarean section because the trauma of surgery slows the intestinal contractions that move waste through the system. (Postoperative narcotic pain medications don’t help, either.) But even if you delivered vaginally, it’s not unusual to go three or four days without a bowel movement, Phelan says.
What you can do Drink a minimum of eight 8-ounce glasses of fluids daily, more if you’re breastfeeding. Also load up on raw fruits and vegetables and other high-fiber foods, such as prunes and prune juice. If this doesn’t help, ask your doctor to recommend a mild laxative such as milk of magnesia or a fiber additive such as Metamucil; don’t use stronger laxatives or suppositories without your doctor’s OK.
Hemorrhoids, or swollen blood vessels around the rectum, usually are the result of constipation or prolonged pushing during labor and can last several weeks.
What you can do Sitz baths and ice packs should provide some relief. Also ask your doctor about using a nonprescription product such as Preparation H or Tucks medicated pads. Or try placing cotton balls soaked in witch hazel on your perineum for a few minutes.
Cramps and bleeding
You may feel cramping as your uterus begins to contract and shrink. The site where the placenta was attached also must heal, which can cause bleeding and discharge, often for up to six weeks. Don’t use tampons, since they can introduce infection; wear heavy-duty, overnight sanitary pads instead. Postpartum bleeding usually is heavier than a menstrual period, but if you pass large blood clots or soak more than one pad per hour, or if the bleeding seems to be increasing, call your doctor.