The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA
An interactive resource for moms on easy steps they can take to reduce exposure to chemical toxins during pregnancy.
Other excellent resources about avoiding toxins during pregnancy
These are easy to read and understand and are beautifully presented.
Cream™ - Natural soothing cream for the perineum – for use
Also as a result of its anti-inflammatory effect, bromelain has
found to dramatically reduce postoperative swelling in controlled
research. Double blind research has found bromelain effective in
swelling, bruising, and pain for women having minor surgery after
birth (episiotomy). [from MotherNature.com's
For the severe tearing, I have a tea bag sort of thing that has
comfrey and plantain in it. My clients really like it for their
I can't say as it works for severe tearing but why not test it.
have a recipe for something called People paste, or (Goose Poops).
can be put just inside where the most soreness is felt and left to
job. Not all day or anything but for an hour or so. Then it can be
This is a real good paste for anything, scrapes, bruises etc.
out. There are only 3 ingredients, equal parts of all 3 powdered,
elm, golden seal and myrrh. This is the base and now for vaginal
you can add comfrey and plantain if wanted. Now you can add clover
if strong pain relief is needed. You can mix these herbs with
aloe vera, water, etc. You want the mixture a little on the med.
so it will stay in a form. Make a big tear drop shape. These can
just slightly or as much as the lady feels comfortable with. At
should be in contact with the damaged tissues. I forgot all about
as I have only been using them for the past 6 months and haven't
use them enough to have it right on the top of my head. I have
the tea bag things for a few years and I have had ladies ask for
Regarding the "tea bag sort of thing": I have found that
coffee filters work really well for this. You can put the herbs in
staple or glue it together. I make them up in bulk and carry them
postpartum visit bag.
Do you mean unbleached paper coffee filters? Do you make a tea or
then, or put these directly on the perineum?
I do both! I pour boiling water over the (single cup size paper)
filter in a small bowl. Let it steep for 10 min. or so and then,
checking for temp, apply it directly on the perineum. I put the
tea water from the bowl in the mom's peri bottle. I do this at the
day visit usually and then leave a few for the mom to use if they
to (and have time). Mom's usually love it!
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
partum bag. the only thing about the staples they might rust
tender tissues. If they rust that wouldn't be very hygienic. Mine
or fused together. I have someone make them. Hope this is clearer.
You can sew these up, too. By hand or by machine. That way you
have metal staples or chemicals from glue on the perineum. I use
fabric to make these, but coffee filters would sure be easier.
Yes, you can boil the fresh leaves and use them for compresses -
the large old leaves will have those little spines on the back.
leaves a lot to break the spines or wrap them in paper towels, or
similar to keep the spines from causing further irritation.
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
summer), uva ursi (helps prevent infection), and rosemary (also
you can, smells great too).
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:
Most of the birth supply houses or birth herbal suppliers carry some kind of sitz herbs or perineal healing salves. mamasoaks.com specializes in organic herbal baths to reduce soreness and swelling of the perineum.
The herbs I use for perineal compresses are the same herbs I use
the herbal bath. We start the tea for the bath while mom is in
then use some for the birth and the rest for the bath. They
rosemary, shepherd's purse, uva ursi, garlic and salt.
Grated ginger steeped in the crockpot water is to increase blood
to the area the compress is applied to, thereby aiding in
we don't get around to using the crockpot water, we might drink it
"perking up" (but not the mom as it can increase bleeding).
We have the parents grate about 1/2 cup, put it in a clean piece
stocking and freeze. When labor starts, put frozen gingerroot in
pot or sauce pan.
The best recovery I've had of my own stitches are the times I
fresh comfrey tea as wash. I'd just keep a squirt bottle of
tea in the bathroom and my healing time was drastically reduced.
offered this suggestion to others and they have reported good
Salt on a wound? On a mucous membrane?
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
actually soothing to open-tissues. You want the salt
be about equal to "the salty taste of blood" -- about a teaspoon
from Gloria Lemay in "Tricks of the Trade" Midwifery Today, Spring, 2009
Putting cold packs on the perineum is something we learned in Western medicine that should now be discarded in practice. Chinese medicine says "never put cold against a new mother or baby" and I have had great success with putting heat on bruised, scraped or torn perineums right after birth. Even thought the tissues feel "hot" after birth, hot compresses give instant relief.
Also, discomfort and swollen tissues can be caused by wearing commercial pads with "extra absorbency" chemicals. After three or four days, the postpartum woman is well advised to stop wearing store-bought pads and switch to cotton reusable pads, cloth diapers or folded face cloths for the remaining days of lochia.
[Ed. Women birthing in warm birthing tubs have the benefit of
on the perineum both before and after birth. The warmth
birth is like a huge hot compress, which seems to help the tissues
nicely. The water pressure reduces swelling during labor and
and the warmth after the birth seems to feel very comfortable.]
My experience has always been that if there is edema in the
the cold will help the fluid redistribute back into the general
over the first 24 hours. Then during the second 48 hours, the
bring healing fluids to the area and promote the further
The only exception to this is if the woman has varicosities in the
and vaginal area, and then we use cold packs during pushing
warm compresses) and for the following 48 hours and not warm sitz
to keep the fluid from accumulating in the vulvar tissues and
I have heard that warmth is best for healing as it brings
to the area, and I know that in many; traditional cultures post
women are not allowed anything cold at all and are kept in very
I prefer heat and strongly recommend it.
I offer moms their choice of heat or cold, and often let them try warmth first. I've never yet had a woman who decided she preferred cold after she'd tried warmth.
I think there is more pain relief, less swelling and faster
of swelling, and faster healing of any tears.
For the moms who birth in the birthing tub and stay in it for
10-20 minutes afterwards, there is very little perineal swelling,
often don't want any cold.
What do you use for a hot pack postpartum? A hot water
Usually the same hotpacks which we've been using during crowning. (well, same water anyway. They need to be clean!)
Sometimes we put ginger and comfrey in the water and that's even better than plain water.
It's really easy to do --- any cloth, washcloth, diaper -- will work for a hot compress.
Someone said that women go "Ahhhh, that feels good" when they get
icepack, but I'll bet if you try a warmpack you'll hear the same
Maybe a longer "Ahhhhhhhhhh".
I think that the warmth actually "prevents" swelling, not just
it. I've been pretty impressed with it anyway.
Start her on stool softeners right away, and then encourage LOTS
LOTS of fibrous fruit juices, water and more stool
softeners. I also
like vitamin C as a mild laxative and its immune-supportive
Remind her not to "push" when moving her bowels, and avoid iron
that could be constipating.
Make sure she has a Fleets enema in case she needs one for a
I tell moms with a repair to take a pad of toilet paper and hold
over the repair - counterpressure. It makes them less
they are pushing hard enough to rip out the sutures.
"Raw honey is a great remedy for first-degree [perineal] tears.
thick consistency forms a barrier defending the wound from outside
The moistness allows skin cells to grow without creating a scar,
a scab has already formed. Meanwhile, the sugars extract dirt and
from the wound, which helps prevent bacteria from growing, while
of honey also slows or prevents the growth of many bacteria. An
that bees add to honey reacts with the wound's fluids and breaks
hydrogen peroxide, a disinfectant. Honey also acts as an
and pain killer and prevents bandages from sticking to wounds.
studies have shown that honey has significant antibacterial
Significant clinical observations have demonstrated the
honey as a wound healing agent. Glucose converted into hyaluronic
at the wound surface forms an extracellular matrix that encourages
healing. Honey is also considered antimicrobial." [Excerpted
for Postpartum Perineum Care: Part I,"The Birthkit, Issue 46]
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
or cracked nipples...adapt to your situation as you see
try cutting TT to 1 drop per cup water and use on breasts between
us posted, please
I've been reading the "honey" mail and thought I'd add my two
worth. I've worked in hospitals and nursing homes over the past 23
and have seen the sugar and or honey use for sores, bedsores
ulcers) over the years. Just thought I'd tell the theory behind
The sugar supposedly feed the bacteria which caused the
the dead tissue and exposed "healthy" fresh tissue. The betadine
to kill off the unwanted more harmful bacteria or "germs". I saw
until about 1987 or so and saw some dramatic wounds get better.
if it was the sugar or not. I wouldn't use this with diabetic
there glucose blood levels are already potentially high sugar
This honey thing sounds great, because I know that honey has some
antibacterial properties. BUT in my wound care seminar this week,
discussing the fact that diabetics take a long time to heal. One
given for that was the high blood sugar that diabetics have.
Hmmm.. but isn't it more a matter of the diabetic not being able
USE that sugar (since they lack insulin, or the insulin they have
Impaired circulation is certainly a large part of the problem
healing. But an important thing to remember about bacterial growth
sugar (think back, way back, to high school biology
with molasses and water...) is that bacteria and fungus feed on
but can only thrive within a relatively narrow range of sugar-
concentration. In other words, very low concentrations of sugar
insufficient nutrition and very high concentrations of sugar
of bacteria. They like their sugar levels juuust right.
I was surprised to find that honey doesn't stick to the pad the
you'd expect it to. It stays moist and soft and almost a bit
forming a layer on top of the skin.
See also: Vulvodynia /
Vestibulitis / Pelvic Pain
I had a severe dermatitis vulvar/vestibular dermatitis after giving birth to my first child in 1974. We determined that part of the problem was an allergic reaction to 1) the betadine used for every vaginal exam in labor (my labia actually swelled shut at one point) and 2) the carrier for the topical anesthetic spray (I had previously had a similar reaction to Solarcaine spray used for sunburn!).
I do not recommend Dermoplast for that specific reason. Epifoam is actually more soothing, if one wants an allopathic remedy.
Also - what suture material did the doc use? I have seen some pretty nasty allergic reactions to both chromic and to vicryl....has she tried PO benadryl?
Estrogen cream may be helpful, too.
Some of my clients have found the OB pads to be very irritating,
the standard ones that might have been bleached with dioxin.
have found great relief by switching to NatraCare pads.
If you had an episiotomy, you can do gentle perineal massage
days after the birth. This will help to prevent the
Before resuming regular sexual activity, some women like to
the vaginal tissues through gentle perineal massage: put the thumb
the vagina and put gentle pressure in the shape of a half moon
to front or front to back. Don't do anything that causes
I'm wondering if any of you have had a problem similar to
What did you do? How long did it take you to heal? Are
breastfeeding-safe foods or herbs that I can consume that would
the healing process? Other advice or support you can offer?
I had a similar problem I had "a small epis" .....( that is
she said I needed after about 15 min of pushing.....but that is
story ) anyway.... sex was uncomfortable right up until my son was
old, I thought this was all a normal part of
helped was astro glide. then one day it was like magic it stopped
I thought to my self wow it took ten months. personally I
mess with injections unless sex was unbearable.
This happened to me when my baby was born. At the time, I
not find anyone who had gone through what I was going through
a new moms group) and I felt alone, like there was something wrong
me. No other new moms I talked to about this had any idea
was talking about. It took a little over a year until it
hurt" anymore. I saw my OB who recommended steroid
one of the problems with that would be injections "down there" (no
and also, it just builds scar tissue faster and potentially more
It "might" have helped heal faster but it would have been
I cannot remember the medical definition of what I had but it was
a hypersensitivity to touch, etc... When the tissue at the
the cut/tear starts to heal the nerves in that tissue
Well, sometimes the nerves don't heal together right and that is
the sensitivity to pain/touch comes from. Some women that
this actually cannot wear underwear, pants, wash themselves, or
down! It can last anywhere from a few months to a few
It is the same thing that happens to women that have had
have scar tissue problems at the site of the incision. I saw
doctors about this and my primary care physician actually knew
it than my OB did and was able to help me more and feel more
about it. He was great about it! :) After talking to
at the office I work at they recommended I go and see a pelvic
therapist. I actually went to see a specialized PT.
some work with me and within a couple of months or so I was
the point of no more pain. It did take over a year to
and it took almost two years before I got a pap again. One
that honestly helps and what the therapist was telling me is to do
massage and kegels. (Done at a certain frequency and
Ironically, but those are two of the things that the PT had me
If anyone you know has this or has had this let them know that
not alone and that there is a light at the end of the
will get better, with the right care/treatment and thinking.
I have a recommendation regarding slow-healing perineal
Medical qigong therapy would probably help. I do a lot of
with neurological issues as chi emission activates neural
Medical qigong therapy is holistic so also can help to release
held in the tissues. As the energetic bodywork is non-touch,
the client fully clothed, it would be quite appropriate for this
chronic health issue.
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.
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