Postpartum Vaginal Care: Hygiene Tips for After Giving Birth

How can I bathe and keep myself clean postpartum?

Good hygiene is important for pain and comfort reasons, but also needed for wound healing and to prevent infection.

• Keep your perineum very clean. This is the area between the vagina and rectum. It can be swollen and painful after stretching to allow the baby to be born.
• Change your pad often. Each time you use the bathroom or change your pad wash your hands both before and after. Be sure to remove the dirty pad and replace a clean pad, from front to back. Change the sanitary pad after every void or bowel movement, or at least 4x a day. Both lochia and feces are a medium for bacteria.
• Use a squirt bottle. It is helpful to use a squirt bottle to wash off after going to the bathroom. You can squirt yourself with warm water from front to back. Gently pat dry with clean toilet paper or clean wipes.
• Soak in a bath. If you have delivered vaginally, soaking in a bath tub can also help with cleaning and wound healing. Be sure to clean the bathtub well, before doing this.
• Use pads, not tampons. Use only sanitary pads to absorb the bleeding. Do not use tampons for the first six weeks, as they can lead to infection.

Your body will begin to pass the blood and mucous built up in your uterus. This flow is called lochia, and it will last about 4-6 weeks. Lochia should have a smell like fresh blood or mucous. The amount may increase slightly when you first get out of bed or standing up after lying down for a period of time , or when you breastfeed.

• For the first 2-3 days, the lochia is dark red and made up of blood and some small clots.
• From day 3-10 the fluid is pink or light brown.
• By about 2 weeks, the discharge will turn to a yellowish-white mucous that can last for another two to eight weeks.

Episiotomy Care

Your health care provider may have made a surgical incision, an episiotomy, to enlarge the vaginal opening. Good hygiene is important. Follow the care for keeping your perineum clean.

• Avoid water that's too hot. If your health care provider placed stitches, they will dissolve over time. Be careful the water is not extremely hot as this could dissolve the stitches too early.
• Use sprays or ointments vs an air ring or donut cushion. Your health care provider may have ordered a spray or ointment that can relieve pain. Follow the provided instructions carefully. Most can be used 3-4x a day. There are also small pads containing witch hazel that can be placed on the sanitary pad are also comforting. The use of an air ring or donut cushion is not recommended.

Incisional care

• Keep incision clean and dry. It is important to keep the incision clean and dry. You can take sponge baths or showers. Drip plain or soapy water over the incision and dry gently with a clean towel. Your incision may itch as it heals. Be careful not to scratch it.
• Staple and stitches removal. If staples are present, they are normally removed around day 3-6. Tiny papers called steri-strips, are often applied after the staples are removed. These will begin to come off or can be peeled off by day 5-14. Your physician may give you more information about the care of steri-strips. Your internal stitches will dissolve on their own. Your health care provider will give you instructions for wound care and when it is okay to shower.
• Watch for warning signs. As you heal, you will need to make sure your incision is healing normally. Contact your health care provider if you have a fever or if the incision becomes red, swollen, oozes pus, or separates.

Hemorrhoid care

These may have developed during pregnancy and increased in size during labor. Pressure associated with hemorrhoids may be very painful and uncomfortable. This may be noticed when sitting, walking and with bowel movements.

• Stay clean. Good hygiene is important. Follow the care for keeping your perineum clean. Make sure you clean your rectal area as well.
• Take pain medicine as needed. After cleaning yourself or soaking in the bathtub. apply topical pain medicine. Follow the provided instructions carefully.
• Prevent constipation. Eating a high fiber diet, drinking plenty of fluids, and keeping your pain at a comfortable level can help with this. Call your health care provider if constipation becomes a problem.

References

AWHONN. (2006). The Compendium of Postpartum Care, 2nd Edition. Philadelphia, PA: Medical Broadcasting Company.
Riley, L. (2006). You & Your Baby: Pregnancy. Des Moines, IA: Meredith Corporation