Doctor's Notes on Postpartum Perineal Care
The perineum is the area between the urethra and the anus. In women, this are includes the vaginal opening. The perineum undergoes stress and change during pregnancy and delivery, and it needs special care afterward. Some women have the perineum surgically cut (episiotomy) when they deliver a baby. Other women perform perineal massage during their pregnancy to prevent pain and other problems after delivery.
Symptoms of injury to the vagina and the perineum during delivery may include pain, swelling, bruising, or a collection of blood under the skin (hematoma). Small hematomas may go away on their own. Larger hematomas may need to be drained. Tears in the tissues (lacerations) may heal on their own or need to be repaired by suturing. The episiotomy will scar as it heals. After giving birth there will be some vaginal discharge called lochia that will be red at first and gradually become white, or clear like mucus.
Postpartum Perineal Care Symptoms
- Small hematomas usually go away without treatment. Painful, large hematomas may need drainage of the blood that collects in them. If a lot of tissue swelling occurs around the urethra, urinating may be difficult. If this happens, a small tube called a catheter can be put into the bladder until urination is possible.
- Lacerations are tears in the tissues. They may be repaired by suturing or sewing, but small ones will heal with normal care.
- As the episiotomy heals, it forms a scar. Women who have episiotomies should be careful to avoid opening the wound while it heals.
- After the baby is born, a discharge called lochia (pronounced LOE-kee-uh) will drain from the vagina. At first, this lochia will look red, because blood is mixed with it. As the woman heals, the lochia will become white or even clear, like mucus.
A typical pregnancy lasts 40 weeks from the first day of your last menstrual period (LMP) to the birth of the baby. It is divided into three stages, called trimesters: first trimester, second trimester, and third trimester. The fetus undergoes many changes throughout maturation.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.