How Do You Care for Stitches and a Sore Perineum After Birth?
October 16, 2026
The short answer
Rinse with warm water from a peri bottle every time you pee or poop and pat dry, don't wipe. Use ice in the first 24 hours, then warm sitz baths a few times a day. Change pads every two to four hours, and take stool softeners so you don't strain. Most tears feel better within a few weeks; call if pain gets worse or the area smells bad.
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Nobody puts this part in the baby shower card. If you have a vaginal birth, the area between your vagina and your rectum (the perineum) is going to be swollen and sore, and if you tore or had an episiotomy, you’ll have stitches there. Healing it is mostly a boring routine. Do the routine.
This is the routine the public guidance describes. Your nurse or midwife will give you your own instructions before you leave; theirs win.
The bathroom routine
Peri bottle, every single time. After you pee or poop, squirt warm water over the area, then pat dry with a clean towel or wipe. Don’t rub. Cleveland Clinic says aggressive wiping is the thing to avoid, and believe me, you won’t want to anyway. The hospital will probably give you a peri bottle. The angled ones (the Frida Mom kit has one) are easier to aim when you can’t see what you’re doing.
Change your pad every two to four hours. That’s MedlinePlus’s number, and it holds even when the bleeding is light. A fresh pad keeps the stitches cleaner.
Cold first, then warm
First 24 hours: ice. MedlinePlus says ice packs in the first 24 hours bring down swelling and help with pain. Cleveland Clinic suggests frozen maxi pads (the internet calls them padsicles), postpartum ice packs, or a sealed bag of ice. Don’t put bare ice on your skin. Instant cold pads are the lazy version: crack one and it’s cold, no freezer trip at 3am.
After 24 hours: sitz baths. A sitz bath is a shallow basin that sits on the toilet seat. You fill it with warm water and sit in it. Warm water brings blood flow to the area. MedlinePlus says several times a day.
Other things Cleveland Clinic lists that help: witch hazel pads laid on top of your maxi pad, a numbing spray, over-the-counter pain relievers, and a donut pillow so you’re not sitting directly on the sore spot.
The first poop
It’s coming, and it’s scary. Cleveland Clinic says it might not happen until day three or four. The plan:
- Take the stool softener if your provider offers one, and drink a lot of water. MedlinePlus says stool softeners plus water prevent constipation. If you need a laxative, MedlinePlus says to use a stool softener or bulk laxative, not enemas or stimulant laxatives.
- Don’t strain. Straining is what you’re trying to avoid with everything above.
- Use the peri bottle afterward. Pat, don’t wipe.
Hemorrhoids are common too. MedlinePlus says ice packs, warm baths, and over-the-counter hemorrhoid creams or suppositories can help.
What to hold off on
MedlinePlus: wait six weeks before you use tampons, have sex, or do anything else that could tear the stitches. Your six-week visit is when you ask about all three.
When it’s not healing right
Call your provider if:
- The pain is getting worse, not slowly better.
- There’s a foul-smelling discharge.
- The wound looks like it’s coming open.
- You have a fever of 100.4°F or higher.
- You’ve gone four or more days without a bowel movement.
- You pass a clot bigger than a walnut, or you soak through a large pad every hour for two hours in a row.
How much bleeding is normal, and for how long, is in how long does postpartum bleeding last?
Instant Ice Maxi Pads
Frida Mom · Available on Amazon
A small buy that earns its spot in the fourth trimester. Cold pad, built-in, no freezer trip at 3am with a newborn attached to you.
- No freezer prep needed
- Fits regular underwear
- Fast relief
- Single-use, go through them fast the first week
Postpartum Essentials Kit (11-Piece)
Frida Mom · Available on Amazon
Buy this before the baby, not after. The witch hazel pads and the peri bottle alone are worth the price. Hospital-issue versions are worse and you'll run out day two.
- Everything in one order
- Peri bottle angle is better than the hospital one
- Padsicle-ready
- You will still need more witch hazel pads by week 2
Follow-up questions
How long do stitches take to heal after birth?
Cleveland Clinic says most tears feel better within weeks and heal completely by the six-week postpartum visit, and the stitches dissolve on their own. Third- and fourth-degree tears can take longer.
When can I take a sitz bath after giving birth?
MedlinePlus says to wait until 24 hours after the birth, then sitz baths several times a day can help. Use ice in that first 24 hours instead.
What helps the pain of a perineal tear?
Cleveland Clinic lists ice (frozen pads, postpartum ice packs or a sealed bag of ice), over-the-counter pain relievers like ibuprofen and acetaminophen, numbing spray, witch hazel pads on top of your maxi pad, and a donut pillow for sitting. Ask your provider which pain relievers are right for you, especially if you're breastfeeding.
Is it normal to be scared of the first poop after birth?
Extremely. Cleveland Clinic notes the first bowel movement may not come until the third or fourth day. Stool softeners, water and fiber make it easier, and straining is the thing to avoid.