Postpartum stitches result from repairing a tear or episiotomy, a common part of vaginal childbirth recovery. During delivery, the perineum—the skin and muscle between the vagina and the anus—can stretch and tear, requiring surgical repair. The resulting pain and discomfort are a normal part of the body’s healing process. Understanding the expected timeline and pain management strategies helps new parents navigate the initial weeks after birth.
Expected Pain Timeline and Types of Stitches
How long postpartum stitches hurt depends on the severity of the initial tear or cut, which is categorized by degree. Acute, sharp pain is typically at its peak during the first three to seven days following birth. This initial discomfort is caused by the trauma of the wound, swelling, and bruising in the surrounding tissues.
The most common repair involves a second-degree laceration, which extends through the skin and into the perineal muscle. Stitches for this type of tear are generally dissolvable and do not need removal, with the wound surface healing within a few weeks. While the stitches dissolve fully within six weeks, many people feel significantly better within two weeks of delivery.
Minor first-degree tears involve only the skin and may not require stitches, healing quickly with minimal pain. Third and fourth-degree lacerations extend into the anal sphincter muscle or rectal lining, requiring more complex repair and a longer recovery. Lingering discomfort, such as a dull ache or pulling sensation, can persist for up to six weeks or longer with these extensive repairs.
Immediate Relief and Pain Management Strategies
Managing peak pain and reducing swelling are the primary goals during the initial days of recovery. Over-the-counter anti-inflammatory medications, such as ibuprofen, target both pain and inflammation. For more severe pain, stronger prescription medication may be provided for a short period.
Applying a cold compress is an effective strategy for the first 24 to 72 hours to numb the area and reduce swelling. Use a dedicated perineal cold pack or ice wrapped in a clean cloth for no more than 20 minutes at a time. A sitz bath, which involves sitting in a shallow basin of warm water, can also provide soothing relief several times a day after the first 12 hours.
Using a peri-bottle filled with warm water helps gently rinse the area during and after urination, diluting urine and preventing stinging. Medicated pads containing witch hazel or topical numbing sprays and foams can also provide temporary relief from surface pain.
Promoting Healing and Recognizing Complications
Promoting long-term healing requires maintaining a clean environment and minimizing strain on the repaired tissues. Keep the perineal area clean and dry by frequently changing sanitary pads and always wiping or patting from front to back after using the toilet. Gently drying the area with a clean cloth or by air drying prevents moisture buildup that could slow healing.
Preventing constipation is crucial, as straining during a bowel movement places direct pressure on the stitches and surrounding muscles. Eat a diet rich in fiber, drink plenty of water, and discuss using a stool softener with a healthcare provider to keep bowel movements soft. Resting and avoiding heavy lifting also support the integrity of the repair.
While some discomfort is expected, certain signs require immediate medical attention. These red flags include a fever, a worsening or sudden increase in pain after the first week, or a foul odor or pus-like discharge from the wound. Contact a healthcare provider immediately if a section of the wound appears to open up or if there is excessive or bright red bleeding.