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Healing after a vaginal birth depends a lot on whether you tore, and how deeply. Enter your birth date and what happened, and get a plain-English read on what's normal at your stage — and what's worth a call rather than a wait.
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If you're not sure, pick the last option — it's a very common thing not to have been told clearly.
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Bleeding is heaviest now — bright red, heavier than a period, often with some clots. Swelling and stinging are at their peak. Ice packs, a peri bottle for rinsing while you pass urine, and staying ahead of pain relief rather than waiting for pain to build all help.
Soreness usually peaks somewhere in this window. Stitches, if you have them, can feel tight and pulling. The first bowel movement worries most people — a stool softener and supporting the area with clean tissue makes it much less alarming than expected.
Bleeding lightens and shifts from red toward pink or brown. Dissolvable stitches usually start breaking down around now, which can feel itchy, and you may notice small pieces coming away — that's expected, not a sign something has gone wrong.
Bleeding tapers to a light yellowish-white discharge. Most external swelling has gone. Sitting is usually comfortable again, though the area can still feel different from before.
Most people are formally cleared at this visit. That's a checkpoint rather than a finish line — the pelvic floor and deeper tissue are still rebuilding well past it.
Scar tissue softens gradually. This is often when people first try sex again, and finding it uncomfortable at first is common rather than a sign of failure. Pelvic floor work in this window makes a real difference.
Tissue remodelling and pelvic floor strength keep improving for the best part of a year. Symptoms still present at six months — leaking, pain, heaviness — are common but not something you simply have to accept; they are treatable.
These terms get used quickly in a delivery room and rarely explained properly afterwards. Here's what each one refers to.
Involves the skin and surface tissue of the perineum only. Often doesn't need stitches, and tends to heal within a couple of weeks.
Extends into the perineal muscle underneath. This is the most common type and is usually repaired with dissolvable stitches. Most of the healing happens over the first few weeks.
A deliberate surgical cut made to widen the opening during delivery. It's repaired with stitches and generally heals on a timeline similar to a second-degree tear.
Extends from the perineum into the muscle that controls the anus (the anal sphincter). It's repaired in an operating theatre and warrants specialist follow-up.
Extends through the anal sphincter and into the lining of the rectum. Like third-degree tears, it's repaired surgically and needs proper follow-up care.
An umbrella term — obstetric anal sphincter injury — covering third- and fourth-degree tears together. If you hear this word about your birth, it means one of those two.
The tool above tells you what's typical for your stage. This is the detail underneath — what the different degrees of tear actually mean, what actually helps the pain, how to get through the first bowel movement, and the signs that mean something is wrong rather than just sore.
If you were told you had "a small tear" or "a couple of stitches", it helps to know which category that was.
First and second degree tears usually heal within about two weeks, and the stitches themselves dissolve in roughly a week. If you feel a stitch working its way out around day seven, that is the process finishing, not a complication.
Cold is the main thing. Cool gel pads in the first twelve to twenty-four hours, or ice wrapped in a cloth — never directly on the skin — for about twenty minutes, repeated roughly every three hours. It reduces swelling, and swelling is most of what you are feeling.
For pain, paracetamol up to 1g four times a day and ibuprofen every six hours are usual, but confirm what suits you with your midwife, especially if you have other conditions. A valley cushion, which supports you either side rather than under the perineum, makes sitting far more bearable than an ordinary ring cushion.
Lie down more than you think you should. Standing and sitting upright both put pressure on healing tissue, and long stretches of either are what people regret on day three.
Almost nobody warns about this, and almost everybody dreads it. Two things make it manageable.
First, stay well ahead of constipation: two to three litres of water a day and enough fibre, from the first day. Stool softeners are available and there is no prize for refusing them.
Second, when the moment comes, hold a clean pad gently against the stitches with your hand as you go. It supports the area and reduces the pulling sensation that makes people hold back — and holding back is what causes the real problem.
Your stitches will not tear open. The fear is far worse than the event.
Not at six weeks. Now, as soon as you can, even gently, even if you can barely feel anything happening.
Early pelvic floor work increases blood flow to the area, which speeds healing, and it begins reconnecting muscles that have been stretched for months. This is the single highest-value thing you can do in the first weeks, and it is free, invisible and takes two minutes.
If you cannot feel the contraction at all, or it hurts, that is worth mentioning rather than pushing through — it is exactly what a pelvic health physiotherapist is for.
Normal: soreness that gradually improves, itching as things knit together, bruising, swelling that settles over the first week, and feeling strange or numb in patches.
Contact your midwife, GP or maternity triage if:
That last one deserves a line of its own. Loss of bowel or wind control after birth is commonly dismissed by women as something to put up with. It is not. It is treatable, it responds much better to early help, and it can indicate a tear that was more extensive than first thought.
Skin heals in weeks. The deeper tissue and the pelvic floor work on a scale of months, and that gap is where most of the confusion lives — you look healed, your notes say healed, and something still feels wrong.
Things worth raising rather than accepting: pain during sex beyond the first few attempts, a dragging or heavy feeling in the vagina, leaking when you cough, sneeze or run, or a scar that stays tight and tender. All of these are common, none of them are inevitable, and all of them respond better to treatment at four months than at four years.
You are entitled to ask for a referral to a pelvic health physiotherapist. You do not need to have a catastrophe first.
Sources: RCOG — First- and second-degree tears · Royal Berkshire NHS — Tears and stitches · Pelvic Obstetric & Gynaecological Physiotherapy — Perineal healing
Dissolvable stitches typically start breaking down within the first couple of weeks and are usually gone by around six weeks, though it varies. Itching as they dissolve is normal; increasing pain, a bad smell or the wound opening is not, and should be looked at.
Because everything down there is sore and it feels as though the stitches might give way. They are stronger than they feel. A stool softener, plenty of fluids, and supporting the perineum with clean tissue while you go makes a real difference — and it is worth asking for a softener rather than waiting to see how it goes.
It's common, particularly the first few times and especially where there's scar tissue. What isn't something to simply accept is pain that continues month after month — that's treatable, usually through pelvic floor physiotherapy, and worth raising rather than enduring.
It often improves as the pelvic floor recovers, but "common" isn't the same as "something you have to live with." If it's still happening at your six-week visit, ask for a referral to a pelvic floor physiotherapist rather than waiting it out.
These injuries warrant specialist follow-up rather than a standard six-week check alone — typically a review with an obstetric team and a referral to pelvic floor physiotherapy. If nobody has arranged that for you, it's reasonable to ask for it directly.
Physically, most people describe turning a corner somewhere between six weeks and three months, with full tissue healing continuing for up to a year. Emotionally it runs on its own clock entirely, and the two don't always line up.