Perineal recovery involves monitoring for infection, recognising wound breakdown, and supporting healing through pelvic floor exercises. Look out for increased pain, swelling or discharge, and seek medical advice if concerned.
Some women may experience troublesome scar tissue. Your healthcare team can guide treatment, recovery and ongoing support.

Infection

Look out for any signs that the cut or surrounding tissue has become infected, such as:   

  • red, swollen skin 

  • your stitches get more painful  

  • discharge of pus or liquid from the cut 

  • persistent pain 

  • an unusual smell. 

Tell a GP, midwife or health visitor as soon as you can about any possible signs of infection so they can make sure you get the treatment you might need. 

Perineal wound breakdown

After childbirth, you may have had stitches to repair any perineal tears, or an episiotomy. It is rare for the stitches to simply come undone, however, occasionally an infection or pressure on the stitches from bleeding underneath can cause the stitches to breakdown, leaving an open or gaping wound. 

This is called perineal wound dehiscence, or breakdown. Wound breakdown can cause an increase in pain, new bleeding or pus-like discharge. You may also begin to feel unwell. 

Sometimes women notice some stitch material coming away soon after they have had their baby or can see for themselves that the wound has opened. 

If you are concerned there is a problem with your stitches you should see a healthcare professional. They will examine your stitches and look for signs of infection. They may take a swab from the perineum to try and find out what is causing the infection. Most women will be given a short course of antibiotics and advised to take pain relief. If the infection is making you unwell, you may require admission to hospital for intravenous antibiotics. 

Strengthening exercises

Strengthening the muscles around the vagina and anus by doing pelvic floor exercises can help with healing and will reduce the pressure on the cut and surrounding tissue. 

Pelvic floor exercises involve squeezing the muscles around your vagina and anus as though to stop yourself from going to the toilet or passing wind. 

A midwife can explain how to do the exercises. You can see more about the role of our pelvic floor and how to keep it strong on our Wellbeing and Exercise in Pregnancy Programme page 

Scar tissue

For a few women, excessive, raised or itchy scar tissue forms around the place where a tear happened or where an episiotomy was done. If your scar tissue is causing problems for you, speak to your doctor. 

It is common to feel pain during sex after an episiotomy of tear in the first few months. See the page 'Your body after birth' for more information on sex after giving birth.