Postpartum Perineal Care
Subsections on this page:
Comfort Measures for Postpartum Perineum
Use of Honey or Tea Tree Oil for Perineal Infection
Postpartum Sex - How Soon?
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Comfort Measures for Postpartum Perineum
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Reusable frozen ice pack
Take a condom and put some alcohol in it- rubbing or drinking- about an inch or so- fill the rest with water- tie a knot in it and then insert it into another condom and tie it like a water balloon also. insert it into a toilet paper tube and put in freezer- a condom slushy to the rescue!
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Also as a result of its anti-inflammatory effect, bromelain has been found to dramatically reduce postoperative swelling in controlled human research. Double blind research has found bromelain effective in reducing swelling, bruising, and pain for women having minor surgery after giving birth (episiotomy). [from MotherNature.com's encyclopedia.]
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For the severe tearing, I have a tea bag sort of thing that has powdered comfrey and plantain in it. My clients really like it for their soreness. I can't say as it works for severe tearing but why not test it. Also I have a recipe for something called People paste, or (Goose Poops). These can be put just inside where the most soreness is felt and left to do their job. Not all day or anything but for an hour or so. Then it can be changed. This is a real good paste for anything, scrapes, bruises etc. Inside and out. There are only 3 ingredients, equal parts of all 3 powdered, slippery elm, golden seal and myrrh. This is the base and now for vaginal tears you can add comfrey and plantain if wanted. Now you can add clover powder if strong pain relief is needed. You can mix these herbs with honey, molasses, aloe vera, water, etc. You want the mixture a little on the med. dry side so it will stay in a form. Make a big tear drop shape. These can be inserted just slightly or as much as the lady feels comfortable with. At least it should be in contact with the damaged tissues. I forgot all about these as I have only been using them for the past 6 months and haven't had to use them enough to have it right on the top of my head. I have been using the tea bag things for a few years and I have had ladies ask for more.
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Regarding the "tea bag sort of thing": I have found that unbleached coffee filters work really well for this. You can put the herbs in it and staple or glue it together. I make them up in bulk and carry them in my postpartum visit bag.
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Do you mean unbleached paper coffee filters? Do you make a tea or infusion then, or put these directly on the perineum?
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I do both! I pour boiling water over the (single cup size paper) coffee filter in a small bowl. Let it steep for 10 min. or so and then, after checking for temp, apply it directly on the perineum. I put the leftover tea water from the bowl in the mom's peri bottle. I do this at the first day visit usually and then leave a few for the mom to use if they want to (and have time). Mom's usually love it!
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You can use the unbleached coffee filters if you want. You do like you are going to make a tea, hot water etc. Put the bag in the hot water just long enough till you see the herbs leak into the water. Then press out the excess water not to much though and carefully separate the labia and set bag on sore tissues or perineum. Leave on till cold dip very fast in to the hot water and turn over the bag and use the other side do the same to the tissues. Can be repeated with same tea bag 3 times on each side.
Can't remember someone else said about stapling and carrying in post partum bag. the only thing about the staples they might rust and/or poke tender tissues. If they rust that wouldn't be very hygienic. Mine are sealed or fused together. I have someone make them. Hope this is clearer.
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You can sew these up, too. By hand or by machine. That way you wont have metal staples or chemicals from glue on the perineum. I use cheesecloth fabric to make these, but coffee filters would sure be easier.
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Favorite Postpartum Herbal Mixtures
Shepherd's purse
uva ursi
comfrey leaves and roots
sea salt
calendula flowers
lavender flowers
1 bulb fresh garlic
myrrh or ginger (optional)
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Yes, you can boil the fresh leaves and use them for compresses - however, the large old leaves will have those little spines on the back. Rub the leaves a lot to break the spines or wrap them in paper towels, or something similar to keep the spines from causing further irritation.
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Here's something I have each of my clients make up at about 37 weeks for sore bottoms (whether they tear or not).
First make up a strong pot of comfrey tea. Bring aprox. 2 quarts of water to a boil, remove from heat then throw in clean fresh comfrey leafs. (about 8-10 large leaves or if not available, about 1/2 to 1 ounce of dried leaves). Let steep overnight or at least 4 or 5 hours.
Then take 4 to 6 large sized sanitary napkins (not the super absorbent b/c they usually contain chemicals - though all store-bought ones probably have dioxins) and cut them in half so you have 8-12 shorter ones. Cover a shallow baking pan or cookie sheet w/sides with foil and lay the pads out. Pour the tea over each pad, soaking well, then put them in the freezer. After they are frozen cover each with plastic wrap (so they don't stick together) and stack them in a container (or not) and keep frozen till birth.
After the birth remove the plastic wrap and cover a pad with a clean sterile wash cloth or several layers of sterile gauze. This feels great on the perineum, aids swelling and the comfrey (which contains allantoin) aids healing. This can go on right away and again after stitches. They can be worn for the next few days. Your regular sanitary pad helps hold it in place, of course change it after about 45 mins to an hour as it gets soggy.
Favorite bath or sitz bath herbs are comfrey (you can get fresh during summer), uva ursi (helps prevent infection), and rosemary (also fresh if you can, smells great too).
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I usually order the herb baths from Cascade; however, I found this "formula" in a magazine or journal. Forgot to write down source so I don't know where I read it. Anyway, here it is:
1/8-1/4 cup sea salt
1 ounce Uva Ursi
2 ounces Comfrey
1 ounce Shepherd's Purse
1 clove Garlic
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The herbs I use for perineal compresses are the same herbs I use for the herbal bath. We start the tea for the bath while mom is in labor and then use some for the birth and the rest for the bath. They include comfrey, rosemary, shepherd's purse, uva ursi, garlic and salt.
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Grated ginger steeped in the crockpot water is to increase blood circulation to the area the compress is applied to, thereby aiding in stretching. If we don't get around to using the crockpot water, we might drink it for "perking up" (but not the mom as it can increase bleeding).
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We have the parents grate about 1/2 cup, put it in a clean piece of stocking and freeze. When labor starts, put frozen gingerroot in crock pot or sauce pan.
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The best recovery I've had of my own stitches are the times I used a fresh comfrey tea as wash. I'd just keep a squirt bottle of lukewarm comfrey tea in the bathroom and my healing time was drastically reduced. I've also offered this suggestion to others and they have reported good results.
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My Favorite Postpartum Sitz Bath Uses
Frozen pads - this is my favorite! - It worked so well for me after having a 3rd degree tear with stitches. I had virtually no pain and no swelling and it was so incredibly soothing. Many of my other clients have said the same thing. Here's how: make the tea as directed. Fold sanitary napkins in half (hold top and bottom ends together with adhesive on the inside and pad on the outside). Dip pad into tea soaking middle of the pad. Lay dipped pads into tupperware or other container side by side. Place waxed paper or saran wrap on top of pad layer and then make another dipped pad layer on top of that (kind of like pad lasagna! The wax paper will keep them from freezing together and becoming one large ice cube). Place entire container of pads in freezer before the birth to have ready. To use: wrap one frozen pad in a nice, soft, white (no colors or design), paper towel) to prevent freezer burn). Place in a waterproof pair of underwear (you can get Kotex Personals at any drug/grocery store and they are perfect. They are disposable, waterproof, reasonably priced and very comfortable.) Or you can use a disposable diaper in your own underwear also. The Kotex Personals are much better, much more comfortable, and less bulky. And then you just wear the frozen pad, which will help with pain and keep the swelling to a minimum, while the herbs help the area to heal. Use a new pad each time you use the bathroom or as you like.
Peri Bottle - make the tea as directed. Pour cooled tea into peri bottle and have available for rinsing vaginal/perineal area during and after urination. This idea is recommended for use along with any of the other ways you choose to use your sitz bath herbs.
Sitz bath - make the tea as directed. Pour tea into sitz bath and soak.
Regular bath - make tea as directed. Add to bathwater and soak. Great for baby too (helps heal umbilical stump).
And don't be afraid to try other ideas you may come up with! There is no wrong way to do this - these are just some ideas to get you started and what I've had success with!
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Salt on a wound? On a mucous membrane?
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yes! I'm surprised you've never heard of this. Soaking wounds in salt water is the oldest medical treatment in history and still one of the most effective and most commonly used around the world.
salt is mildly antiseptic. Salt water promotes healing. Salt water is actually soothing to open-tissues. You want the salt solution to be about equal to "the salty taste of blood" -- about a teaspoon tablespoon per pint.
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Use of Honey or Tea Tree Oil for Perineal Infection
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TEA TREE OIL...essential oil antifungal, antibiotic, antiviral promotes healing of tissue, reduces risk of infection bonus...relieves itching!
absolutely fantastic results with vaginal yeast, pimples, sores, bug bites, itching sites of any kind...applied neat in all but mucous membrane and large wound applications (have, out of desperation, personally applied neat vaginally/orally on myself :-}). When used on abraded vaginal tissue can cause a stinging/tingling sensation that myself and others report as fleetingly strong but welcome. The spray formula below brings cooling relief immediately in even strong candida overgrowth vaginally...just made up a new batch last evening to treat vaginal candida overgrowth of my own.
formula: 3 drops of tea tree oil (essential oil only!), 1 cup DISTILLED water, put in mister bottle and spray away
DISCLAIMER: have not yet had the need to use this with nursing newborns or cracked nipples...adapt to your situation as you see reasonable. (maybe try cutting TT to 1 drop per cup water and use on breasts between nursing??).....keep us posted, please
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I've been reading the "honey" mail and thought I'd add my two cents worth. I've worked in hospitals and nursing homes over the past 23 years and have seen the sugar and or honey use for sores, bedsores (decubitus ulcers) over the years. Just thought I'd tell the theory behind it's use. The sugar supposedly feed the bacteria which caused the destruction of the dead tissue and exposed "healthy" fresh tissue. The betadine was used to kill off the unwanted more harmful bacteria or "germs". I saw this used until about 1987 or so and saw some dramatic wounds get better. Don't know if it was the sugar or not. I wouldn't use this with diabetic persons because there glucose blood levels are already potentially high sugar levels.
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This honey thing sounds great, because I know that honey has some great antibacterial properties. BUT in my wound care seminar this week, we were discussing the fact that diabetics take a long time to heal. One reason given for that was the high blood sugar that diabetics have.
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Hmmm.. but isn't it more a matter of the diabetic not being able to USE that sugar (since they lack insulin, or the insulin they have is no longer effective)?
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Impaired circulation is certainly a large part of the problem with diabetic healing. But an important thing to remember about bacterial growth and sugar (think back, way back, to high school biology experiments with molasses and water...) is that bacteria and fungus feed on sugar, but can only thrive within a relatively narrow range of sugar- to-substrate concentration. In other words, very low concentrations of sugar provide insufficient nutrition and very high concentrations of sugar inhibit growth of bacteria. They like their sugar levels juuust right.
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Postpartum Sex - How Soon?
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6 weeks is usually mentioned because that's when the postpartum checkup is usually scheduled. For women who've had episiotomy wounds or significant suturing of tears, it makes sense to make sure they're well healed before being subjected to the stress of intercourse.
A woman who wants to have this checked sooner than six weeks could schedule an appointment earlier. (Six weeks is chosen as the timing for the last normal postpartum checkup because the uterus has usually completed its return to a nonpregnant state by then. If you schedule your appointment earlier than six weeks, you might be advised to schedule another appointment to check the uterus.)
The cervical os is generally closed to infection by 3 weeks postpartum and has resumed its nonpregnant state by 4 weeks postpartum. For a woman with an intact perineum, her decision to resume intercourse after 4 weeks can be safely based on desire and comfort. |
