Pain management is an important part of the healing process. There are several ways to combat discomfort:

• Sitz baths
• Ice packs
• Frozen padsicles

If your doctor approves, take an over-the-counter pain- or inflammation-reducing medication like acetaminophen or ibuprofen.

You can also use a topical numbing spray such as Dermoplast (benzocaine rectal ointment or spray) to help reduce perineal discomfort.

Avoiding constipation is important as your perineum heals. Remember to:

• Drink plenty of water
• Eat foods with fiber such as vegetables, fruits, and whole grains
• Take a stool softener or fiber supplement, as recommended by your doctor
• Try perineal massage and self-acupressure

Use a perineal irrigation (peri) bottle to spray warm water on your perineum during and after urinating to ease the burning. This will also help keep everything clean and avoid infection. Then, pat gently with medicated pads, clean toilet paper, or a baby wipe. Don’t rub.

As your perineum heals, you may feel itchy due to vaginal dryness, changing hormones, stitches, or postnatal bleeding (lochia). Itchiness can also be a sign of healing, or of a yeast infection. The following may help relieve itchiness:

• Use sitz baths and peri bottles for good postpartum hygiene.
• Wear loose-fitting underwear.
• Hydrate.
• Use natural, pH-balanced soaps and detergents.
• Try a natural vaginal moisturizer.
• Apply ice packs and witch hazel pads.
• Try salt baths to support the perineum, if your doctor approves.
• Use a benzocaine rectal ointment or spray, or other topical agent.

• Foul-smelling discharge from your vagina
• Burning pain with urination
• Passing urine more frequently than usual
• Urge to pass urine frequently, but only passing a small amount
• Vaginal bleeding after your sixth postpartum week
• Severe pain in your perineum, pelvis, or lower abdomen
• High fever when you are not sick otherwise
• Passing gas or stool through the vagina
• Passing sutures or sponges
• Blistering or herpes
• Persistent perineal irritation resistant to remedies outlined in “How to solve itching.”

• A fever high enough that your provider recommends in-person evaluation
• Nausea and vomiting
• Severe abdominal or pelvic pain
• Heavy vaginal bleeding in which you are soaking through more than one pad every hour