How long do perineal stitches take to heal?

Skin can feel better in 1–2 weeks, with deeper tissues maturing over several weeks. Most stitches dissolve by 6 weeks.

Can I take a bath or use a sitz bath?

A short, warm **sitz bath** is often recommended for comfort. Follow your provider’s guidance about full bathtub soaks.

When can I start pelvic floor exercises?

Begin with **relaxation and breath** right away if comfortable; add gentle contractions only when pain allows and your provider approves.

Perineal Tear & Stitches Care: Exact Healing Timeline and Comfort Tips After Birth

Understanding Perineal Tears (1st–4th Degree)

The perineum is the area between your vagina and anus. During vaginal birth, it can stretch or tear. Tears are graded by depth:

1st degree: Skin only. Usually minimal stitches, quick recovery.
2nd degree: Skin + muscle (most common). Needs stitches; several weeks to settle.
3rd degree: Extends into anal sphincter muscles.
4th degree: Extends through the anal sphincter into the rectal mucosa.

Your discharge summary should list your tear degree. If you’re not sure, ask your provider. Knowing the grade helps set realistic expectations.

How Stitches Heal (and What You Should Feel)

Stitches hold tissues together while your body knits beneath. Early on, expect:

Tenderness and stinging with movement.
Pulling sensation at the stitches.
Itching later (a sign of healing).
Spotting that ebbs and flows with activity.

Pain should trend down week by week. If it worsens or spikes suddenly, pause and reassess activity.

The Week-by-Week Timeline (Typical)

Week 0–1: Protect and Soothe

Swelling and tenderness highest.
Sitz baths (10 minutes warm) 1–2×/day for comfort.
Rinse with warm water after peeing/pooping; pat dry (no rubbing).
Sleep/rest positions that avoid pressure (side-lying is king).
Avoid constipation (hydration, fiber, stool softener if provider approves).

Week 2–3: Settling

Less stinging; stitches may begin to dissolve.
Sitting becomes easier with cushion adjustments (U-cutout or soft wedge).
Short walks (5–10 minutes) 1–2×/day; stop before pain.
Begin down-training (breath + relax) to reduce guarding.

Week 4–6: Confidence Returns

Most feel much better sitting and on the toilet.
Gentle pelvic floor re-engagement can begin if comfortable: tiny lifts on exhale, full release on inhale.
Provider clears you for progressive activity at your check.

Beyond 6 Weeks

Tissues continue to remodel. If pain persists with sex or sitting, consider pelvic health PT—scar mobility and coordination make a big difference.

Every body and every tear is different. Use your comfort as the guide and your provider’s plan as your anchor.

Comfort Protocol (Daily)

Clean, Dry, and Calm

Rinse with warm water after toileting.
Pat (don’t rub) dry with soft tissue or a clean cloth.
Change pads often; breathable underwear helps.
Air time: when possible, lie on a towel without underwear for short periods to let skin breathe.

Temperature for Relief

Warm sitz bath: relaxes muscles and soothes.
Cool gel pads: briefly if swelling is bothersome.

Positions That Help

Side-lying for feeds and naps to offload the perineum.
Tripod sitting (weight on sit bones and thighs, not tailbone/perineum).
Use a coccyx-cutout cushion if needed; avoid ring donuts that concentrate pressure.

Bathroom Strategies (No Straining)

Hydrate steadily (aim for pale yellow urine).
Fiber + healthy fats: oats + chia, prunes/pears/kiwi, olive oil, veggies/legumes.
Footstool under your feet; lean forward.
Exhale gently and allow a soft belly bulge (instead of pushing).
Support with a folded tissue or clean pad against the perineum if it makes you feel safer.
If no bowel movement by day 3–4 despite strategies—or you have severe pain or bleeding—call your provider.

Pain Relief: What’s Typically Used

Discuss ibuprofen/acetaminophen with your provider (and compatibility if breastfeeding).
Topical sprays or pads may help; follow your discharge instructions.
Avoid fragranced products on sensitive skin.

When and How to Start Pelvic Floor Work

Early focus is relaxation and blood flow:

Breath practice (2–3 minutes): Inhale wide into ribs/belly (visualize the pelvic floor softening). Exhale long through pursed lips (belly falls).
Gentle mobility: Pelvic tilts, cat–cow, supported child’s pose—no pain.

When tenderness is low and cleared by your provider:

Micro lifts on exhale (8–10 reps)—think “pick up a blueberry” and fully let go on the inhale.
Stop with any stinging or pulling; return to down-training and try again in a few days.

Scar Care—When You’re Ready

Once the area is healed and your provider says it’s okay:

Start with desensitization: light touch around (not across) the scar with clean hands, 60–90 seconds.
Progress to tiny circles and gentle skin lifts adjacent to the scar (never forcing).
Goal: restore glide so movement and intimacy feel normal again.

If touching the scar feels scary or painful, a pelvic health PT can guide you step by step.

Sex After a Tear: Comfort First, Timeline Second

Lubrication is essential (breastfeeding lowers estrogen → dryness).
Start with zero-pressure intimacy (cuddling/massage) before penetration.
Positions you control like side-lying or woman-on-top reduce pressure and allow pacing.
Stoplight rule: Green = stretch/pressure; Yellow = discomfort (add lube/change angle/slow); Red = pain (stop and reset).
If pain persists, see our postpartum painful sex guide and ask your provider about local treatments or PT.

Red Flags: Call Your Provider

Spreading redness, warmth, or foul odor.
Fever/chills or feeling unwell.
Worsening pain or wound separation (gaping).
Persistent heavy bleeding or egg-sized clots.
Bowel or bladder control changes.

Early help prevents setbacks—don’t wait.

A Gentle 10-Minute Daily Routine

Breath + relax (2 minutes).
Sitz bath (optional) or warm rinse after toileting.
Mobility mini-circuit (5 minutes): pelvic tilts, cat–cow, supported child’s pose.
Short walk (3 minutes) or as tolerated—movement is medicine.

When comfortable and cleared:

Add micro lifts on exhale (8–10 reps), 3–4 days/week.

Mindset: Healing Isn’t Graded by Speed

You may hear stories of people who “felt fine in a week.” That’s great for them—and irrelevant to you. Heal on your timeline. Small, repeated comforts compound: sitz, breath, food, fluids, and kind movement. Your body knows how to mend; you’re just giving it a calm environment to do so.

Bottom Line

Perineal tears are common and recoverable. Most stitches dissolve within weeks while comfort steadily returns. Keep the area clean and dry, avoid straining, and favor side-lying or pressure-smart sitting. Add relaxation first, then gentle re-engagement when it feels right. If anything worries you—call. You deserve reassurance and relief.