# Healing After a Vaginal Birth: Tears, Stitches and Perineal Care

> How to care for a sore perineum, tears and stitches after a vaginal birth, and what normal healing looks like.

Stage: family - Topic: For parents - Page: https://www.askcladle.com/guides/parents/vaginal-birth-recovery-and-perineal-care

Grounded in: ACOG guidance on postpartum care and on obstetric lacerations, ACOG "Exercise After Pregnancy", and CDC Hear Her urgent maternal warning signs. Summarized in Cradle's own words; none of these sources endorse Cradle. Your own midwife or OB comes first. General information, not medical advice.

Reviewed: 2026-11

## TLDR

- Most tears heal well; use cold packs in the first 1-2 days, a peri bottle when you pee, and warm sitz baths after.
- Soreness should ease every few days, with most first- and second-degree tears much better by 2-3 weeks.
- Call your provider if pain worsens, the area is hot, red or oozing, or you have a fever of 100.4°F (38°C); call 911 if you soak a pad in an hour and feel faint.

## Tears and stitches

- Most people who give birth vaginally for the first time have some tearing. Tears are graded 1 to
  4: first and second degree involve skin and muscle and heal well; third and fourth degree reach
  the anal sphincter and need extra follow-up.
- Stitches usually dissolve on their own within a few weeks. You may find bits on your pad.
- An episiotomy (a cut) heals like a second-degree tear.

## The first few days

- **Cold:** ice packs or a chilled pad for 10-20 minutes at a time in the first 1-2 days ease
  swelling. Put a thin cloth between ice and skin.
- **Peri bottle:** squirt warm water over the area while you pee to dilute the sting, then pat dry
  front to back. Don't wipe.
- **Numbing spray or cooling pads** from the hospital can help; ask what's safe.
- **Pain relief:** take the medicines your provider recommends on a schedule for the first days.
- **Lie down** often, on your side, to take pressure off the perineum and reduce swelling.

## The first weeks

- **Warm sitz baths** (a shallow soak) a few times a day after the first day or so feel good and
  keep the area clean.
- **Sitting:** a pillow or folded towel under each thigh is often better than a ring cushion.
- **Pads, not tampons,** until your provider says otherwise. Change them every 4-6 hours.
- **Bowels:** drink water, eat fiber, use the stool softener you're offered, and don't strain.
  Pressing a clean pad against your stitches when you poop can make it feel safer. Your stitches
  won't burst.
- **Hemorrhoids** are common and usually shrink over weeks; cool packs and avoiding straining help.
- **Leaking** a little urine with a cough or sneeze is common early on and often improves; see the
  pelvic floor guide.
- **Look:** a hand mirror at a week or two can be reassuring. Swelling and bruising fade; the area
  usually looks more like itself by 6 weeks.

## How healing usually goes

- Soreness should improve a bit every few days. Most first- and second-degree tears feel much better
  by 2-3 weeks.
- After a third- or fourth-degree tear, ask for a check at 2 weeks or so and a referral to pelvic
  floor physical therapy. Some people need a longer course; that's common, not a failure.
- Sex and exercise: see the sex and birth control guide and the pelvic floor guide.

## When to check in

- Mention at your postpartum visit any pain with sitting or sex, leaking of urine, gas or stool, or a
  bulge or heaviness.
- Contact your provider soon if pain gets worse instead of better, the area is hot, red or oozing,
  there's a bad smell, the wound opens, you can't pee, or you have a fever of 100.4°F (38°C) or more.
- If you're soaking a pad in an hour and feel dizzy or faint, call 911.