The perineum is the part of your body between your legs, including the vagina (birth canal) and rectum. After having a baby, you need to give this area special attention. Postpartum perineal care includes all the things you need to do to make the area feel better, heal properly and avoid infections. You will need to do this for 1 to 3 weeks.

Causes
The perineum is severely stressed as a baby is pushed through the vagina (birth canal). Also, the doctor may have made a small opening called an episiotomy so that the vagina wouldn't tear when the baby was coming out. Although this is sewn back together, it will take time to heal.

Signs/Symptoms
There will be pain and swelling around the vagina because of stretching when the baby was born. You ill also notice a discharge from the vagina. At first it will be bloody, then it will turn pink. Later it will turn yellow and then go away. You may have a tear in your vagina. You may also have stitches in your vagina.

Sometimes because of pushing and staining, hemorrhoids may occur around the rectum. A hemorrhoid is a bulge in a blood vessel that can be very sore. hemorrhoids feel worse when you are sitting up.

Care
You may need ice packs or an ice sitz bath to relive the pain right after you give birth. You may be given pain medicine and you also may get sprays or wipes that contain a numbing agent to help ease the pain. In addition, your doctor may give you medicine to help soften your stools so that it doesn't hurt as much when you go to the bathroom.

Keeping the area clean with a peri-bottle (a hand-held squirt bottle) can be soothing and help prevent infections. You will also need to use peri-pads in your underwear to catch the blood and discharge from he vagina.

What should you do?

• Keep a supply of the following items at home: peri-pads, peri-bottle, toiler paper or cotton wipes, pain medicine such as acetaminophen and other medicines your doctor asks you to take.

• Check the mount and color of the discharge from your vagina. This shows how fast you are healing. For the first 2 to 3 days after you have had your baby, the blood will be a heavy flow and dark red. Some women pass clots and blood for 3 to 5 days. From 3rd to the 10th day, the discharge gradually becomes pink and the flow is lighter. After that you will have a creamy or yellowish discharge for another 1 to 2 weeks.

• Clean the perineal area each time you use the toilet or change your perineal pads. Proceed as follows: Use a hand-held squirt bottle (peri-bottle) filled with warm tap water. While sitting on the toilet rinse your perineum for at least 2 minutes. Aim the water from front to back. Pat the area dry with toilet paper or cotton wipes again from front to back. Put on a fresh perineal pad. Stand up before flushing the toilet to avoid being spayed with the toilet water.

• Sitz baths during the fist week may help you feel better. Fill the bathtub with warm water. Sit for 10 minutes twice a day. Put on fresh perineal pad after the bath.

Contact your doctor if

• Your vaginal discharge gets heavier (soaking 1 pad every 1 to 2 hours), turns bright red, develops a bad smell.

• You start having a high temperature.

• You have pain in the abdomen.

Source: The PDR Family Guide, Encyclopedia of Medical Care (1997)