As birth and postpartum doulas, you will assist clients in preparing for and thriving through healing after birth. If you’re a new postpartum parent, you’re likely looking for tips to help with healing the perineum.
Many parents do a great job preparing for baby. They have the registry done, have searched for the best diaper brand, and even have the top diaper creams ready to go. Unfortunately, some aren’t prepared to care for mom’s bottom after birth!
As a doula, or a parent, it’s important to know how to support postpartum healing, including for the perineum.
6 Tips For Healing The Perineum
The state of the perineum after birth will often depend on how labor unfolded.
Some experience no tearing, just swelling and discomfort. Others experience natural tears (from minor lacerations to needing several stitches) or require episiotomies.
Whether one experiences minor discomfort, a natural tear or an episiotomy, there are several things which can offer relief and promote healing.
Here are 6 tips healing after birth:
#1: Apply Witch Hazel
Many expectant parents are already stocked with witch hazel. Witch hazel offers relief for uncomfortable hemorrhoids.
However, it also offers soothing relief from postpartum swelling, painful or irritated stitches, and any hemorrhoids which worsen or arrive with birth.
Many find freezing witch hazel pads and sticking them on their sanitary pads offers tremendous relief. The herbal remedy plus the coolness offers double the soothing power. It greatly reduces the swelling while offering some relief for the discomfort.
#2: Sitz Bath For Healing The Perineum
Sitz baths can help soothe swelling, irritated stitches, and help with hemorrhoids. Sitz baths can also help to speed up postpartum perineal healing.
A sitz bath sits on top of the toilet and allows you to soak your bottom in a few inches of water.
Many like to add herbs, Epsom salts, and essential oils to their sitz baths. As doulas, we cannot prescribe specific herbs and oils, but we can point them to resources. Premade sitz bath herb packs like ones from an herbalist, can be a safe way for us to support our clients in finding and using natural remedies.
Jade Groff is a CNM, herbalist and more who is qualified to prepare herbs for sitz baths. You can learn more on her site about sitz baths and herbs.
#3: Apply Ice Packs
Cool compresses help reduce swelling associated with tears and pain. In some cases, there can be labial swelling even without irritation or abrasions. This can be normal due to excess fluid, common during pregnancy and the postpartum period. Ice may not reduce that swelling as much, but it can reduce swelling associated with tears, stitches, and bruising.
Some birthing facilities provide prepackaged perineal cool compresses. These do not require a freezer and are activated when bent in half. A great tip for your clients is to tell them to request a few extra to take home.
Parents can also prepare by putting some water (and even a bit of witch hazel) in a newborn diaper or sanitary pad and freezing them. This creates a perfectly sized and shaped cool compress for the perineal area.
#4: Use A Peri Bottle
A peri bottle (a little squirt bottle) given at many birthing facilities, can be very helpful in the postpartum period. Wiping after urinating or having a bowel movement needs to be done with care. Using a peri bottle to rinse before wiping can make gentle wiping more efficient.
As a doula, you can remind your clients to make sure to grab the peri bottle from their facility.
Some find they have difficulty urinating in the immediate postpartum, period. Using a peri bottle with warm water can help some better empty the bladder by triggering them to relax and release.
#5 – Careful Bowel Movements To Prevent Further Perineal Trauma
Pregnancy, birth, the postpartum period can lead to lots of thoughts about poop. Prior to pregnancy it is likely something that rarely took much thought. Many are very anxious about their first postnatal bowel movement. Some find it extremely uncomfortable, while for others, it’s all about the anxiety.
As a doula, you can help prepare your clients for this sometimes unexpected post-birth reality.
Depending on how birth goes, and if there’s use of pain medications, constipation can contribute to postpartum discomfort.
Many providers recommend stool softeners. As a doula, you cannot directly tell your client to take a stool softener. However, you can advise them that many providers recommend them, and should their provider do so, it’s ideal they head that advice. You can also suggest they talk to their provider about taking a stool softener preventively if their provider does not bring it up.
Staying well hydrated, eating foods naturally high in fiber, and using any stool softeners as recommended by providers can help one get passed the first few postpartum bowel movements.
#6: Encourage Plenty Of Postpartum Rest
Growing a baby and birthing that baby (or babies!) is a big task worthy of lots of recovery. It’s important to encourage clients to listen to their body.
For clients with multilevel homes, remind them to prepare so they needn’t use the stairs many times a day. Setting up nesting areas on each floor (especially the floor with the bathroom) can be a great way to reduce overall stair usage. Using the stairs too often can cause more perineal and pelvic floor discomfort.
It is also important to be conscious of lifting.
In the early days and weeks, parents should do their best to focus on feeding, bonding and resting. The more one rests, the more opportunity for healing. Strict bedrest is rarely encouraged, we do need to move a bit, but clients should not be lifting a ton, doing many stairs, or walking long distances in the early days and weeks.
Whether you provide birth or postpartum services, it’s important to help your clients know how to best recover from pregnancy and birth.
Author: Aliza Juliette Bancoff
Aliza Juliette Bancoff is a well-known doula and doula trainer who has been providing doula services to families for over a decade. She is the founder of Main Line Doulas, a doula group providing doula support in the great Philadelphia area for the last decade, the International Doula Institute, which provides online doula training and lactation training and certification programs and the International Breastfeeding Institute which provides lactation training and certification. She is the co-founder of United Birth, a company devoted to increasing access to doulas across the country to make the perinatal time safer both physically and emotionally. “Every birthing person deserves access to quality doula support. And we are working to make that a reality across the country. The work we are doing to get doulas to every birthing person will decrease the black infant and maternal mortality rate significantly by 2030.” Says Bancoff. Aliza is known for her compassionate and empowering approach to doula work, and she has been featured in numerous media outlets, including United Nations Maternal Health Report, Parent Magazine, CafeMom, theBump and many more. Aliza's journey into doula work began when she gave birth to her first child and felt a strong calling...