Keeping Me Well - Cardiff and Vale University Hospital

Perineal Wound Issues

The perineum is the area of skin and muscle between the vaginal opening and the anus (back passage).

Download our Wound Care Leaflet for more information about looking after your perineal wound until it has healed.

Complications with the perineum during delivery

  • Perineal tear: during birth the perineum stretches and this makes the tissues thinner which can sometimes cause this area to tear. The extent of this tear can vary.
  • Episiotomy: an episiotomy is a cut in the perineum made by your midwife or doctor during delivery. This helps to widen the vaginal opening, allowing more space for your baby to be delivered. The episiotomy will be sutured and these stitches usually dissolve with 10 – 15 days.

Complications with your perineal wound

Most perineal wounds heal well.  It is important however to be aware of possible complications and the resultant signs and symptoms to look out for in order to highlight them to your midwife as soon as possible.


A haematoma is a blood clot which can form underneath the wound. This can impede the healing of the wound so it is important that it is identified early. These symptoms are usually more apparent in the early stages.

Signs & symptoms of a haematoma

  • Intense pain
  • Inability to sit directly onto the wound
  • Feeling like you are sat on a ball
  • Difficulty walking

Wound Infection

There is a higher chance of infection in perineal wounds due to their location.
An infection usually becomes obvious at around 3 – 5 days.

Signs & symptoms of infection

  • Feeling generally unwell (flu-like / feverish)
  • Increasing pain
  • Offensive odour
  • Yellow discharge / pus coming from the wound
  • Difficulty walking

If you have any of these symptoms please speak to your midwife as soon as possible, as the wound will need to be examined and you may need to start a course of antibiotics.

If the stitches come undone and the wound opens up do not panic – they will rarely re-suture the wound and it usually heals well.

Physiotherapy Treatment

Your Midwife or GP may refer you to Physiotherapy if you have developed a haematoma or if the perineal wound has broken down (become infected or opened up).  You will be contacted by telephone usually within 48 hours in order to arrange an assessment appointment.

Possible treatment options include Omega Laser  (for wound breakdown) and Pulsed Shortwave (for haematoma). Both treatments are relatively quick and will not cause you any pain or discomfort.

Keeping Me Well - Cardiff and Vale University Hospital

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