Episode 20: Perineum care after giving birth
Welcome to Pregnant in the Netherlands, your guide to pregnancy, birth, and beyond. In this episode, we continue our conversation about perineal care after birth, with practical tips for healing, comfort, and recovery—whether or not you experienced tearing.
I’m Anna, a birth and postpartum doula, childbirth educator, and lactation counselor, alongside Julianna, a birth doula and childbirth educator. We support parents in the Netherlands with evidence-based information, honest conversations, and practical guidance for pregnancy, birth, and postpartum.
Understanding Your Perineum After Birth
After birth, with or without tearing, your perineum is not damaged. It’s open, tired, probably warm, and healing. The goal is to rest, nourish, and support tissue repair.
Some important points to know:
Tearing is common in first-time parents: 60–70% experience some degree of natural perineal tear.
Degrees of tearing:
First and second degree: skin and some muscle involved; very common.
Third and fourth degree: less common, require more attention and careful repair.
Healing takes time: it’s okay if your body hasn’t fully healed by the 6-week checkup. Hormones and tissue repair continue for months.
Daily Care Tips for Comfort and Healing
Air and rest:
Spend some time each day without underwear or pads.
Use a waterproof pad to catch any bleeding and allow your perineum to breathe.
Keep yourself warm and supported in bed—avoid rushing out.
Cleaning and hygiene:
Use a peri bottle or gentle water spray after using the toilet instead of rough toilet paper.
Pat gently with a cloth rather than rubbing.
Cooling or warming:
Some cultures use cold packs for swelling; others recommend warm water.
Choose whatever feels best for you.
Herbal sitz baths:
Warm water with herbs like chamomile, calendula, lavender, or rosemary can reduce inflammation, soothe tissue, and support circulation.
Even a few centimeters of water in a small bath or specialized toilet device can help.
Belly binding and massage:
Belly binding supports pelvic organs and can be part of a closing ritual.
Gentle full-body strokes from head to toes can relax your pelvic floor and perineum, which aids healing.
Partners can also help with these massages.
Rest, Movement, and Recovery
Minimize stairs and unnecessary movement, especially in homes with steep stairs.
Traditional advice: three days in bed, three days on the bed, three days around the bed—focus on resting and recovery.
Accept help from family or partners; avoid “superhero” expectations.
Nutrition and Bowel Care
Eat well-balanced, easily digestible meals like soups, stews, and fiber-rich foods.
Include healthy fats (ghee, olive oil, butter, avocado) to help ease the first bowel movements.
Use a foot stool for a natural position on the toilet.
Avoid prolonged standing or sitting; lie down as needed.
Stitches and Medical Care
Dissolvable stitches usually disappear within 10–14 days.
Watch for signs of infection: itching, redness, foul odor → contact your midwife.
Avoid sliding in bed; lift your body to protect stitches.
Pelvic floor physiotherapy is recommended 6 weeks postpartum, even without complications.
Sex and Intimacy After Birth
Take your time—there is no rush to resume sexual activity.
Explore different ways to connect with your partner beyond full intercourse.
Use lubrication if breastfeeding.
Check in with yourself and your partner; stop if you feel pain or discomfort.
Scar Care and Body Awareness
Perineal scar massage can begin once the skin is fully closed and infection-free.
Use neutral massage oil and gentle circular movements outward.
Scar massage can be emotional; it helps you acknowledge and appreciate your body’s resilience.
For C-section scars: silicone patches or gentle massage support healing and tissue repair.
Key Takeaways
Healing takes time and patience—it’s normal if recovery extends past 6 weeks.
Rest, nourishment, and gentle care support both physical and emotional recovery.
Pelvic floor physiotherapy and guided perineal care can enhance healing and comfort.
Intimacy and sexuality can look different postpartum—there’s no one “right” way.
Join Our Community
If you live in Eindhoven and want to connect with other expecting or postpartum parents:
Join our Expecting Together WhatsApp group
Attend an Expecting Together Meetup
Learn more about our postpartum and birth support services:
