Private parts after birth

What does it feel like after you’ve birthed a baby vaginally? Unfortunately, your private parts can hurt after birth and you’ll probably be uncomfortable for a few weeks after delivery. Here are a few things you may experience and ways to make yourself feel better.

Vaginal soreness

Episiotomies and spontaneous perineal tears are common during delivery and are often the cause of prolonged discomfort. You can improve your comfort as you heal by applying ice packs, using sitz baths, and sitting carefully on cushions or padded rings. Using a bottle to spray your private areas with warm water during and after you use the toilet may also help relieve some of the discomfort. 

Vaginal discharge

In the days after delivery, a heavy flow of blood (called lochia rubra) will transition to a lighter flow of red/pink/brown discharge (called lochia serosa). Over the next few weeks, this will again gradually transition to a yellow or white discharge (called lochia alba). Discharge after vaginal delivery normally resolves between 4 and 6 weeks after delivery.

There are a few warning signs to be aware of during this time. If you are ever bleeding heavily enough to saturate a pad in an hour, or if you are passing blood clots the size of the palm of your hand or larger, that is too much bleeding and you should contact your provider or go to the emergency room for evaluation. Also, if you develop a fever or notice your discharge has an unpleasant odor, or your uterus becomes tender to the touch (the bump in your lower belly), talk to your healthcare provider. Use sanitary napkins rather than tampons, menstrual cups, or any insertable device to reduce the risk of infection.

Trouble with urination

Childbirth can affect the tissue around your urethra and bladder, which might mean you’re peeing too much or not enough. Look for signs of urinary tract infections, specifically pain during urination or unusually frequent trips to the bathroom.

Leaking urine is common in the months after delivery, so doing kegels to tighten your pelvic muscles is a good idea once your provider has cleared you to do so. You should call your healthcare provider if you feel you aren’t urinating enough or if you have the sensation of a full bladder but are unable to pass urine. You should also talk to your healthcare provider about any leakage of urine or stool that you notice.

Bowel management

Constipation after birth is common, but there are ways you can find comfort, including using stool softeners and fiber supplements. If these are not helpful, contact your doctor for help. Some people may experience fecal incontinence postpartum, and while this can be distressing, your provider can walk you through the treatment plan that’s best for you. 

Perineal pain

The area between your vagina and anus stretches a lot during vaginal childbirth. If you have stitches from a tear, your recovery may be more painful. Many of the things you can do to care for vulvar soreness is also helpful for perineal pain. 

Try placing a witch hazel pad on your perineum. You can find pre-soaked witch hazel pads (usually marketed for hemorrhoid relief). Chill them in the refrigerator or freezer for a soothing cooling effect. In some cases, providers will prescribe medication to help with perineum pain. If your pain is worsening or not improving with pain medication, this could be a sign of something more serious and you should contact your provider right away. 

Sitz bath

Sitz baths are another great option to aid with the healing process. You can either take a sitz bath in a bathtub or use a sitz bath bowl 2-3 times a day. Sitz baths involve exposing your perineum to warm water with medication or salt (depending on what your provider recommends) for 10-20 minutes. Let’s talk about your options. 

Bathtub sitz bath

If you have a bathtub at home, fill the clean tub with warm water, and — depending on what your provider recommends — add in medication or salt. When you’ve filled the bath, lower yourself slowly into the water until the affected area is submerged and breathe deeply. Like when salt gets in a cut, you might feel a stinging sensation at first, but it should ease after a minute or two. Heat application can also be used in tandem with cold for numbness, and witch hazel, a natural astringent that can help soothe pain or itching.

Sitz bath bowl

If you don’t have a bathtub at home, or you’re worried about lowering yourself into one, a sitz bath bowl is a good option — you can find them at most pharmacies. Place your sitz bowl securely on the toilet rim and fill it with warm water (make sure the temperature is comfortable). As with the sitz bath, add in medicine or salt (depending on your provider’s recommendation). The specific way that the bath bowl is filled and emptied varies depending on the brand, so make sure to read the instructions. Lower yourself down until you’re sitting on the bath bowl. 

Signs you should talk to a provider right away

• While bleeding in the first few weeks is normal, reach out to your provider if you’re experiencing heavy bleeding, passing large blood clots, or if light bleeding turns into heavy bleeding. 
• Severe or worsening pain around a C-section incision or perineal tear.
• If you develop a fever this could be a sign of an infection. 
• Vaginal discharge that smells bad could be a sign of BV (bacterial vaginosis) or a uterine infection
• Signs of a UTI, like burning when you urinate or a need to go more often than expected 

Taking care of yourself while taking care of a newborn can be overwhelming. And while you should be back to feeling like yourself soon, don’t hesitate to reach out to your provider for guidance on physical healing and/or emotional support. 

This content was reviewed by Dr. Lisa Hickman and Dr. Katie Propst. Dr. Hickman runs the Childbirth Pelvic Floor Disorders Clinic at The Ohio State University Wexner Medical Center. Dr. Propst runs the Postpartum Care Clinic at Cleveland Clinic.