For the first 24 hours, it is important to lie down for approximately 20 to 40 minutes each hour to reduce swelling and assist healing.

If you have lower-back pain, lying on your side is often more comfortable.

Wrap ice or a cold pack in a thin piece of dampened cloth, and apply it to the sore area for 10 to 20 minutes at a time, repeating each hour as necessary.

You can also put an ice pack in the inside lining of a sanitary pad, or use a frozen pad or diaper as a cold compress.

This is especially important in the first 24 hours to help decrease swelling and ease pain. 

Shower or bathe every day. If you have a first- or second-degree tear, consider taking sitz baths after your first couple postpartum days.

Taking sitz baths—soaking your pelvic floor for 10 to 20 minutes several times a day—can help reduce irritation and swelling.

Studies show that cold sitz baths relieve pain more effectively than warm ones. Start with lukewarm water, and gradually add ice cubes.

Check with your physician before adding medications or epsom salts. After each sitz bath, dry any tears or stitches by gently patting them with a towel or using a hair dryer on cool.

With an extra-sensitive perineum, you cannot wipe as you normally would when using the bathroom. Instead, use a squeeze (or peri) bottle.

Hospitals often send mothers home with a peri bottle to help keep the area clean without friction. You can use this squirt bottle to wash away urine, feces, or anything containing bacteria that could induce irritation or an infection.

When finished, gently pat the area dry with baby wipes, medicated pads, or clean toilet paper.

Once the wound is healed, you can wipe gently from front to back.

Soak a pad in aloe and/or witch hazel, freeze it, and place it either between a sanitary napkin and your perineum or directly on the area for cooling relief.

Change your padsicle at least every four hours to reduce the risk of infection.

The “pelvic elevator” can help strengthen your pelvic floor while reducing perineal pain and swelling. Try a set of three of these exercises each hour.

• Imagine your pelvic floor is an elevator in a three-story building
• Sit upright on a chair and breathe in, lengthening your spine
• Hold your breath, and feel your pelvic floor squeeze, closing the elevator door
• Exhale
• Breathe in, keeping the elevator doors closed and lifting your pelvic floor to level two
• Exhale
• Breathe in as you lift your pelvic floor to level three
• Breathe out as you release your pelvic floor to ground level

When sitting, use a pillow, padded ring, or inflatable “donut” cushion for 30 or fewer minutes.

Making slight adjustments to your sitting position is important during this time to avoid blood pooling.

If you’ve undergone perineal repair, try to sit with your legs together rather than crossed.

Drink plenty of water to avoid constipation. Straining with bowel movements will stretch the perineum and can cause pain.

You can also avoid constipation by eating fiber-rich foods such as fresh fruits and vegetables.