Childbirth is an amazing experience, but it can leave you, as a new mom, facing some physical and emotional hurdles, especially with perineal tearing.
What is a perineal tear?
The perineum is a delicate area between the vagina and the anus and 85% of women experience some form of perineal tear during vaginal delivery. The tear can be as small as an abrasion or a minor first-degree tear, affecting only the skin, to more severe third- and fourth-degree tears, which extend into the muscle and the anal sphincter.
How do I know I have a perineal tear?
If you have a perineal tear after pregnancy you may likely experience the following:
Pain or tenderness in the perineal area
Swelling or bruising around the perineum
Discomfort or pain during urination
Difficulty sitting or walking comfortably
Bleeding or discharge from the tear site
Pain during bowel movements
Incontinence (in severe cases)
Pain or discomfort during sex
What causes a perineal tear?
You may be at an increased risk of perineal tearing depending on:
Size and position of the baby
Speed and force of delivery
Elasticity of the mother's perineal tissues
Use of instrumental delivery methods (forceps or vacuum)
First-time vaginal birth
Prolonged second stage of labor
You may think of these factors as out of your control, but there are proactive steps you can take to minimize the risk and promote faster recovery. One thing that lowered my risk was perineal stretching (not massaging).
How can I manage my perineal tear naturally?
In modern healthcare, perineal tears are treated with surgical repair, pain management, and rest. Tears are typically sutured to promote tissue healing, and pain relief is provided through medications. Antibiotics may also be given to prevent or treat infections. But healing is deeper than that. There are still many home-based strategies to focus on for proper healing.
Nutritional Strategies to Support Perineal Tears
A diet rich in vitamins and minerals supports tissue repair and overall healing and for those still perinatal, it can lower the risk of perineal tearing.
Increase foods rich in:
Vitamin C (citrus fruits, strawberries, bell peppers): Tissue repair.
Zinc (nuts, seeds, whole grains): Cell growth and immune health.
Protein (legumes, tempeh): Tissue repair.
Vitamin A (carrots, sweet potatoes, spinach): Skin and immune health.
Iron (beans, lentils, fortified cereals): Oxygen transport to tissues.
Essential fatty acids (flaxseeds, chia seeds, walnuts): Reduces inflammation and aids healing.
B vitamins (leafy greens, whole grains, nutritional yeast): Energy and cell repair.
Vitamin E (almonds, sunflower seeds, avocados): Protects cells and tissue repair.
Magnesium (dark chocolate, nuts, leafy greens): Muscle relaxation and reduces inflammation.
Vitamin D (fortified plant milks, mushrooms): Immune and bone health.
Selenium (Brazil nuts, sunflower seeds): Antioxidant and immune health.
Copper (nuts, seeds, whole grains): Collagen formation and tissue repair.
Biotin (nuts, seeds, sweet potatoes): Skin health.
Folate (leafy greens, legumes, citrus fruits): Cell division and tissue repair.
Calcium (leafy greens, fortified plant milks, tofu): Muscle function and cellular processes.
Phosphorus (legumes, nuts, whole grains): Bone and tissue health.
Vitamin K (leafy greens, broccoli, Brussels sprouts): Blood clotting and wound healing.
Decrease foods that cause inflammation and delay the healing of cells and tissues, like:
Processed foods
Sugary snacks and beverages
High-fat and fried foods
Caffeinated drinks
Alcohol
Spicy foods
High-sodium foods
Artificial sweeteners
Dairy products (if lactose intolerant)
Gluten (if sensitive or intolerant)
Physical Activity and Techniques
Rest is important after pregnancy to help heal the perineal and pelvic floor areas. The first 30-40 days after birth are crucial because healing during this time affects your long-term health.
Proper rest can prevent problems and help you recover better.
More things to consider during the 30 to 40-day resting period are:
Avoid crossing your upper legs during this period.
Keep the perineal area clean and dry.
Use a perineal bottle to gently clean the area after using the restroom.
Wear loose, breathable clothing to reduce irritation.
Use a donut-shaped cushion when sitting to alleviate pressure on the perineal area.
Practice deep breathing exercises to promote relaxation and reduce stress.
Elevate your feet when lying or put a thick pillow under your knees to improve circulation.
Apply a warm compress to the perineal area to soothe discomfort.
In the first 24 - 72 hours use cold packs to reduce swelling.
Stay hydrated (3L) to support overall healing and prevent constipation.
After the first 30-40 days, light exercises like walking and pelvic floor exercises can help blood flow to the perineal area. This encourages it to heal faster and strengthens the muscles.
Exercises to do:
Kegels
Pelvic Tilts
Bridges
Walking
Cat-Cow Stretch
Seated Forward Bend
Deep Breathing
Exercises to avoid (for at least 3 months pp)
High-impact activities like running or jumping
Heavy lifting or weightlifting
Intense abdominal exercises such as crunches or sit-ups
High-intensity interval training (HIIT)
Activities that involve a lot of bending or twisting
Strenuous yoga poses or pilates moves
Any exercise that causes pain or discomfort or overstretches the perineal area
Long-distance walking or hiking
Cycling, especially on rough terrain
Swimming if you have open wounds or stitches that haven't fully healed
Additional lifestyle Considerations
Sleep: Sleep plays a crucial role in allowing the body to heal and rejuvenate overnight.
Manage Stress: Use mindfulness, meditation, and support from family and friends to reduce tension and stress, which can affect healing.
Reduce Toxins: Avoid harmful substances like alcohol, heavy metals, pesticides, processed foods, artificial additives, BPA in plastics, phthalates in personal care products, and tobacco as they negatively affect immunity and tissue healing.
Connect: Get support from community groups and healthcare providers to reduce emotional stress.
What herbs can be used to heal the perineum?
A few of my favorite herbs have anti-inflammatory, astringent, antimicrobial, vulnerary, and emollient-like actions.
Witch Hazel reduces swelling and tightens the skin.
Calendula reduces swelling and promotes tissue repair.
Aloe Vera soothes and supports wound healing.
Comfrey aids wound healing and tissue repair.
You can use these herbs in sitz baths, perineal cold pack pads, or perineal sprays to boost healing.
What role do mental health and spirituality play in perineal healing?
I learned that your spiritual and mental health affect childbirth and healing too.
High stress, anxiety, and distress can make your muscles tense, making the perineal tissues less flexible and more likely to tear.
A negative mindset can make pain management and relaxation harder during childbirth, increasing the risk of tears.
Physical pain can also lead to vulnerability, frustration, and anxiety, affecting recovery and caregiving, and can cause feelings of inadequacy or guilt.
So, a positive spiritual and emotional outlook is important for healing.
Practices like mindfulness, meditation, open communication, and family support can help manage stress and promote relaxation, aiding in prevention and physical recovery.
Also, spiritual practices like prayer can facilitate smoother, faster healing, helping new mothers feel balanced and resilient during recovery.
When should I contact a healthcare provider for this condition?
Always reach out to your doctor if you are experiencing severe or burning and stinging pain, excessive bleeding, or increased swelling of the tissue.
Key Points
Avoid heavy activities at least 30 days before and after labor that could strain the perineal area. Strong and flexible pelvic floor muscles can help prevent tearing during delivery.
Childbirth can cause perineal tears or episiotomies in about 85% of women who have vaginal deliveries.
Factors like the baby's size and position, delivery speed, and the mother's tissue elasticity affect perineal tearing.
Perineal tears can be minor or severe, causing pain, swelling, and difficulty sitting or walking.
Good postpartum care, including herbal remedies, balanced nutrition, and pelvic floor exercises, can help with perineal healing.
Emotional and mental support is important for overall well-being and recovery during postpartum.
Encourage faster healing with herbs like witch hazel, calendula, aloe vera, chamomile, lavender, and comfrey in a sitz bath or perineal spray.
Nutrients like vitamin C, zinc, protein, vitamin A, iron, omega-3, omega-6, and B vitamins are important in healing perineal tissue.
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