Your perineum is the small area of skin and muscle located between the vagina and the anus.
By the third trimester of pregnancy, your baby is gaining weight and dropping lower in your pelvis. The added pressure can lead to swelling of the genitals and perineum. At the same time, your perineum is starting to stretch in preparation for childbirth.
A sore perineum due to pregnancy is a temporary condition, though it can be uncomfortable.
The perineum is stretched even more during childbirth. It’s not uncommon for the perineum to tear as your baby passes through.
According to the American College of Nurse-Midwives (ACNM), anywhere from 40 to 85 percent of women have a tear during vaginal delivery. About two-thirds of them require stitches to repair the damage.
To decrease the chances of a ragged tear, your doctor may cut the perineum. This procedure is called an episiotomy. This gives baby more room to pass through without causing severe tears.
Whether you experience a tear or have an episiotomy, your perineum is a delicate area. Even tiny tears can cause swelling, burning, and itching. A large tear can be quite painful. Episiotomy stitches can feel sore and uncomfortable.
The symptoms can last a few days to several months. During that time, it may be difficult to sit or walk comfortably.
Pregnancy and childbirth are the most common causes of a sore perineum. Other things can lead to a sore perineum, but it’s not always easy to find the cause.
Something as simple as tight pants or sitting in an uncomfortable position for too long can cause soreness of the vulvar area or perineum. Intercourse without sufficient lubrication can also cause a sore perineum.
Generalized vulvodynia refers to a chronic pain in the vulvar area without an obvious cause. The pain can affect the entire area, including the labia, clitoris, and perineum.
Descending perineum syndrome occurs when the perineum balloons beyond its standard positioning. This might happen if you have an ongoing problem defecating or urinating and you strain too hard. If you have a descending perineum, the first step is to determine the cause.
It could also be referred pain. If you have unexplained pain, a healthcare professional will likely begin with a complete gynecological examination to diagnose the concern.
A 2013 study indicated that some women have a higher risk for certain types of perineal tearing during childbirth. Risk factors include:
delivering a baby when you’re an adolescent
being 27 years old or over
having a baby with a high birth weight
having an instrumental delivery
Having more than one of these risk factors makes a perineal tear significantly more likely. In this case, your doctor may consider an episiotomy to try and prevent a tear.
If you have a sore perineum, sitting can make it worse. One simple and inexpensive fix is a hemorrhoid or donut cushion to keep your weight off of your perineum when you sit.
Massaging the area during pregnancy may help relieve soreness and prepare the perineum for childbirth.
Some women find that using an ice or a cold pack relieves symptoms such as swelling, itching, and burning of the perineum. However, a 2007 paper, updated in 2019, concluded that there’s only a small amount of evidence that cooling treatments are safe and effective in relieving perineal pain.
If you’ve experienced a tear or an episiotomy, your doctor will provide aftercare instructions. It’s important that you follow them carefully.
They’ll probably give you a perineal irrigation bottle. You can use it to squirt warm water on the area to clean and soothe it, especially after going to the bathroom.
To help prevent infection, you’ll need to keep the area very clean. A warm, shallow bath may help temporarily relieve discomfort. Use a clean towel to pat yourself dry rather than rubbing the area. You shouldn’t have a bubble bath or use other products with harsh ingredients until it’s completely healed.
Taking care of vaginal tears: Are you missing a step?
Will the soreness eventually get better?
How much soreness you have and how long it will last can vary depending on the person. It has a lot to do with the cause. If you’ve had extensive tearing and swelling, it may take longer to heal.
For most people, childbirth-related soreness of the perineum subsides within a few days to a few weeks. There are usually no long-term effects.
Reach out to a doctor if the soreness doesn’t seem to be improving or it’s getting worse. You should also call a doctor if you have:
problems with perineal stitches
If you’re prone to perineal soreness, try to avoid wearing pants that are too tight. You should also make sure you’re well lubricated before having intercourse.
If you’re pregnant, you might benefit from a perineal massage. According to Brighton and Sussex University Hospitals, studies show that in a first pregnancy, perineal massage after the 34th week can reduce perineal tearing.
To prepare for self-massage, the ACNM suggests you cut your fingernails short and wash your hands well. Relax, with your knees bent. Use pillows for added comfort.
You’ll need to lubricate your thumbs as well as the perineum. You can use vitamin E oil, almond oil, or vegetable oil. If you prefer, you can use a water-soluble jelly. Don’t use baby oil, mineral oil, or petroleum jelly.
Insert your thumbs about 1 to 1.5 inches into your vagina.
Press down and to the sides until you feel it stretch.
Hold for 1 or 2 minutes.
Use your thumbs to slowly massage the lower part of your vagina in a U shape.
Concentrate on keeping your muscles relaxed.
Massage the perineum this way for about 10 minutes per day.
If you’re not comfortable doing it yourself, a partner can do it for you. Partners should use the same technique, but with index fingers instead of thumbs.
Do perineal massages make labor less painful?
How to Ease Vaginal Swelling During Pregnancy
Swelling is a common side effect of pregnancy, especially when it comes to your feet and hands. But there’s one area that can also swell during pregnancy that doesn’t get a lot of attention: Your vagina. If you notice you have a swollen vagina during pregnancy, know you’re not the only woman going through this! Still, we’re guessing you might have questions about why this is happening. Here’s what you need to know, plus how to minimize the swelling and ease any discomfort.
In this article: Symptoms of vaginal swelling during pregnancy What causes vaginal swelling during pregnancy? How to reduce vaginal swelling during pregnancy How to prevent vaginal swelling during pregnancy
Symptoms of Vaginal Swelling During Pregnancy
Every woman and every pregnancy is different—which means the symptoms of vaginal swelling during pregnancy can differ from person to person. In general, though, you might experience the following:
• Noticeable swelling. You’re probably familiar on at least some level with what your vulva and vaginal area usually feels like. If it’s swollen, it can feel noticeably bigger or puffier, says Frederick Friedman, Jr., MD, associate professor of obstetrics, gynecology and reproductive science at the Icahn School of Medicine at Mount Sinai in New York City. “There may just be a general feeling of swelling or fullness in the vaginal area,” adds Julie Lamppa, APRN, CNM, a certified nurse midwife at Mayo Clinic, which can lead to overall discomfort.
• Bumps. Some women who experience vaginal swelling during pregnancy can have varicose veins surface in their vulvar area, which can cause swelling and a bumpy feel down there, Lamppa says.
• Itchiness. This isn’t the case for every woman, but itchiness can sometimes accompany vaginal swelling, Lamppa says.
What Causes Vaginal Swelling During Pregnancy?
There are several reasons why you might develop vaginal swelling in pregnancy. Here are some of the most common ones:
• An increase in blood volume. Your blood volume increases during pregnancy to help support the growing baby. As your uterus grows, there’s also an increase in pressure of the blood vessels in your pelvis, Lamppa explains. The combination of these two things can lead to swelling.
• Varicose veins in your vulva. Varicose veins are swollen, bumpy veins that develop when valves let blood pool in one spot or flow backward. Just like you can develop varicose veins in your legs, you can also develop these in your vulva during pregnancy, Lamppa says. “These aren’t dangerous, but they can be alarming to women when they suddenly show up.”
• A yeast infection. Yeast infections are common among moms-to-be, and they can also lead to a swollen vagina during pregnancy, Friedman says. “The inflammation that results from the infection can cause more swelling,” he explains.
• Excess fluid. Excess fluid can get trapped in your body’s tissues during pregnancy, and that can cause swelling down there, Friedman says.
How to Reduce Vaginal Swelling During Pregnancy
If you suspect that your vaginal swelling is due to excess fluid, compression or support stockings might help. “There are products on the market that you can buy that give vulvar support,” Lamppa says. (Just check in with your doctor first to make sure it’s okay for you to use.)
For direct relief, Lamppa recommends applying a cool pack directly to your vulva. That should help with discomfort as well as cut down on some of the swelling.
If you’re experiencing vaginal swelling along with symptoms of a yeast infection—such as an itchy vaginal area during pregnancy, accompanied by white vaginal discharge—Lamppa recommends seeing your doctor for an evaluation. If they determine that you do, in fact, have a yeast infection, your care provider will likely recommend that you use an over-the-counter cream.
How to Prevent Vaginal Swelling During Pregnancy
Sorry, but there isn’t a ton you can do to lower the odds you’ll experience vaginal swelling during pregnancy, given that it’s a normal side effect of being pregnant, Lamppa says. However, doing your best to avoid sitting or standing for long periods of time may be helpful, Friedman suggests.
While it’s pretty common, it’s a good idea to flag any vaginal swelling during pregnancy for your care provider so they can help pinpoint the cause and get you sweet relief ASAP.
Updated January 2020
Frederick Friedman, Jr., MD, is an associate professor of obstetrics, gynecology and reproductive science at the Icahn School of Medicine at Mount Sinai. He also serves as director for both the division of obstetrics and the division of generalists in the department of obstetrics, gynecology and reproductive science at the Mount Sinai Health System, and maintains a clinical practice in general obstetrics and gynecology.
Julie Lamppa, APRN, CNM, is a certified nurse midwife and medical editor at Mayo Clinic, and maintains a midwifery practice in Rochester, New York.
*Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances. *
Plus, more from The Bump:
Swelling in Pregnancy: Why It Happens and How to Deal
How Your Vaginal Discharge Can Change During Pregnancy
10 Surprising Pregnancy Symptoms No One Warned You About
Pregnancy edema, pregnancy edema
Pregnancy edema is mainly divided into generalized (widespread) and local (local).
Edema is a symptom that occurs in various conditions of the body, characterized by the accumulation of excess fluid in the tissues and / or cavities of the body.
Accumulation and stagnation of fluid in tissues is the release of fluid from a vessel or cell into the intercellular space.
With generalized edema, fluid can accumulate not only in the tissues, but also in the cavities - abdominal, pleural, pericardial. Such edema in pregnant women is rare. More often, swelling is local, for example, they affect the nasal mucosa, the so-called rhinitis of pregnant women) and even the inner ear (feeling of stuffy ears). With swelling of the legs during pregnancy, pressing a finger on the lower leg causes the formation of a hole that does not smooth out for a minute, or even a few.
decrease in plasma protein levels
occur when the level of protein in food falls below the usual level. These edema are characteristic of starvation, stressful extreme situations. For example, in the Leningrad blockade or in concentration camps, the vast majority of people had such edema.
decrease in blood plasma salt levels and release of salts (usually sodium) into the intercellular space
edema associated with malnutrition - both with an excess of salts, and with their deficiency. They occur as a result of the unreasonable use of diuretics for edema during pregnancy and diuretic herbs.
increased vascular (capillary) permeability
Inflammation, intoxication, disorders of nervous regulation.
It must be understood that the very fact of pregnancy and the presence of sources of progesterone provokes the appearance of edema. First, the corpus luteum, then the placenta, produce progesterone, the hormone of the second phase of the menstrual cycle. By itself, progesterone contributes to the accumulation of fluid in the tissues.
Some women have swelling in the second phase of the menstrual cycle - they have a high sensitivity of the receptors even to the small level of progesterone that the corpus luteum produces. At the end of pregnancy, progesterone provides fluid accumulation in the extravascular (interstitial) space. The accumulation of fluid during physiological pregnancy usually ranges from 1-2 kg. , But it can be up to 4 kg.
Part of the edema can compensate for excessive blood loss during childbirth and is the supply of fluid that will enter the bloodstream if necessary. Parturient women with moderate edema can tolerate blood loss more easily and recover faster.
What to do about swelling during pregnancy (general recommendations)
Urine analysis in the 3rd trimester should be checked every 2 weeks. It is necessary to ensure that there is no protein in the urine, and the level of leukocytes does not rise above "5".
Almost all edemas are treated with contrast procedures, a contrast shower, and best of all, a bath followed by dousing with cold water or a font. This improves the functioning of peripheral capillaries and enhances the outflow of fluid from the intercellular space.
Never limit fluids and exclude salt from the diet.
Diaphragmatic breathing (abdominal breathing) allows you to increase the flow of lymph and its return to the venous bed.
Causes of edema in pregnant women and help in case of their occurrence
Asymmetric edema (for example, swelling of one leg). Physical therapy, compression stockings, osteopathic consultation, bandage can help. Diaphragmatic breathing.
The deep veins of the lower extremities and the veins of the small pelvis suffer. Help is the same. Phlebologist, hematologist consultation.
Edema associated with incorrect position
Swelling of the fingers during pregnancy in the morning ! with a decrease in mobility during sleep (usually a month before delivery). Swelling of the legs from habit of sitting cross-legged or on a chair with a hard edge. Help - Rest against the door jamb, make several circular movements in the shoulder joints.
Edema associated with nutrition
With a sharp decrease in protein in the diet, after 2-3 weeks, Braxton Higgs contractions may become more frequent. It is necessary to introduce vegetable and / or proteins into the diet. See Nutrition for pregnant women.
Swelling of the nose
Often associated with sleep disturbance. Help – sauna visits, yoga breathing practices, aromatherapy – Breathing oil, inhalation of lemon peel, bird cherry branches, Rinorin, homeopathic preparations – Fleming’s ointment, Euphorbium compositum nasentropfen C. consumption of clean water in the morning. Cucumbers - as a source of mineral salts. Raw beets in the form of salad or diluted juice - as a source of potassium. Mineral water, fruit drinks, dried fruit compote. Decrease in the diet of dairy products and, especially, milk. Diet for edema during pregnancy, using buckwheat with vegetables. (see "Unloading diet").
What conditions are accompanied by edema in pregnant women
There are threatening conditions during pregnancy, which can also be accompanied by edema. The most formidable are preeclampsia and eclampsia . This condition is not always accompanied by significant swelling, but they can accompany it. For control, it is necessary to take a urine test in the 3rd trimester every 10-14 days and control blood pressure every 3-5 days.
The appearance and increase in the level of protein in the urine, an increase in blood pressure, and in some cases the development of edema require careful observation by an obstetrician-gynecologist and, often, hospitalization in the pregnancy pathology department. Preeclampsia goes away only after childbirth, you can try to restrain its development with the help of treatment, but this condition does not reverse. The trigger mechanism for preeclampsia is not exactly known in medicine.
Often before childbirth, edema decreases due to hormonal changes, weight is reduced by 1-2 kg without dietary measures. This is good.
Sometimes, on the 3rd day after childbirth, edema of the lower extremities may appear, associated with an increase in prolactin and a rush of milk. These edema will pass for 10-14 days.
We wish you a harmonious pregnancy!
Author: Lidia Shenderova, midwife. Family Childbirth Center "Rainbow", St. Petersburg.
Edema (dropsy) during pregnancy
Edema during pregnancy
It is normal for swelling to occur during pregnancy, especially in the legs, ankles, feet and fingers. It often gets worse at the end of the day. Swelling that comes on gradually is usually not dangerous for you or your baby, but it can be uncomfortable.
Consult a gynecologist on whatsapp 💬
If you notice swelling in your hands, ankles and feet, try not to worry. Swelling of the hands, ankles, and feet is very common during pregnancy, especially in the third trimester. Swelling is caused by your body holding on to more fluid than usual. You can get rid of swollen hands, feet and swollen ankles by staying active and drinking plenty of water. Sometimes swollen hands and feet can be a sign of something more serious.
For example, if swelling bothers you in the last trimester of pregnancy and persists. During this period of pregnancy, many expectant mothers experience impaired lymph and blood flow. This contributes to fluid retention in the tissues and the formation of edema. As a result, dropsy of pregnancy develops .
Dropsy during pregnancy
This is a form of toxicosis, in which edema does not disappear from the woman's body, but only increases in size (weight is growing rapidly), in the absence of protein in the urine and normal blood pressure. Violation of water-salt metabolism in the body can pose a serious danger to the health of the expectant mother and baby. In the absence of proper treatment, dropsy can develop into preeclampsia (a severe form of toxicosis). Therefore, at the first signs of this disease, you should immediately go to the hospital.
Dropsy is considered an early manifestation of gestosis, characterized by fluid retention in the body and the appearance of edema.
The following stages are distinguished in dropsy:
1 Stage of dropsy - swelling of the legs (stop and lower legs)
2 Stages of dropsy - swelling of the legs and anterior abdominal wall of the abdomen
3 stages of the butter , abdomen, hands and face
Stage 4 dropsy - generalized edema
Below we provide additional tips to reduce pregnancy swelling and explain when you should still be concerned about swelling during pregnancy.
Causes of swelling (dropsy) during pregnancy
As your baby grows, the expanding uterus presses on the blood vessels in the pelvic area.
Particularly affected are the large veins on the right side (inferior vena cava), which receive blood from the lower extremities. The pressure from your baby and uterus slows down blood flow in this area and causes water to pool from your blood vessels into the tissues of your legs and feet. This can cause swelling of the ankles and legs.
Your hands may also swell towards the end of your pregnancy. If you wear rings, they can put pressure on your fingers and you may have to give them up for a while. Hot weather and standing for long periods of time can also increase swelling.
Up to 80 percent of healthy pregnant women suffer from edema in late pregnancy.
Diagnosis of dropsy in pregnancy
When should I be concerned about swelling during pregnancy?
Swelling during pregnancy is normal and although annoying, it is usually not a big deal. However, very rarely it can still be a sign of a serious illness.
Edema can develop into a form of toxicosis such as dropsy. This can be determined by a sharp increase in weight. Of course, all pregnant women gain weight throughout pregnancy and swelling can also appear periodically and this is absolutely normal, but it is necessary to ensure that the indicators on the scales do not exceed 200-300 grams per week. Also common signs that dropsy is developing can be called:
constant feeling of thirst;
If you experience sudden or severe swelling of your hands, face, or feet, call your doctor or midwife right away. This may be a sign of preeclampsia, which is a serious condition that can harm you and your baby and also affect your blood pressure.
Call your healthcare provider if you notice excessive and/or sudden swelling in your feet or ankles, especially if it is accompanied by any of the following signs of pre-eclampsia:
Headache that doesn't go away
Sudden weight gain
Changes in vision, blurred or bright spots
Pain in the upper abdomen
Shortness of breath
Swelling of hands or face more than moderate
Nausea or vomiting after 20 weeks of pregnancy
Danger of edema in pregnancy
If only one leg is swollen and hot, seek medical attention immediately. There is a small chance it could be due to a blood clot. This is called deep vein thrombosis (DVT) and you will need medical attention.
Symptoms of DVT include:
pain, swelling, or tenderness in one of the legs, usually the lower leg
severe pain and warm skin in the area
red or discolored skin, especially on the calves
Both preeclampsia and DVT can be dangerous for you and your baby, but they can be managed. The sooner you get tested, the better.
Risk of dropsy in pregnancy
What can be done to reduce swelling?
Staying active can help reduce swelling because it stimulates circulation. Try incorporating a couple of walks into your daily routine, or making a few changes to your regular habits, such as getting off the bus a stop early and walking the rest of the way, or taking the stairs instead of the elevator.
You may have heard that diuretics help your kidneys pass water and sodium so you can get rid of excess fluid in your body. However, they are not recommended for normal pregnancy edema, as by washing out important elements, diuretic tablets can harm the fetus.
How to reduce swelling during pregnancy
Your doctor may only suggest that you take them if you have other complications such as heart disease or kidney problems.
Instead of using diuretics, try the following methods for edema:
Drink plenty of water as this will help your body eliminate excess water.
Try wearing compression garments, stockings or knee socks. This will especially help relieve your swollen feet and swollen ankles.
Get a professional foot massage or ask your partner for a relaxing hand or foot massage.
Tips for swelling during pregnancy
Raise your legs whenever possible as this will improve circulation . At work, keep a footstool or box under your desk. At home and in bed, try to lie on your side, as this reduces pressure on the inferior vena cava and is safer for your baby. Place a pillow under your ankles to elevate your legs at night.
Try not to stand on your feet for too long. Take regular breaks from work. Your employer is required to conduct a risk assessment of your position and do everything possible to reduce the health risks to you and your child.
Leg exercises can help reduce ankle swelling. Bend the leg up and down 30 times, then twist it eight times in one direction and eight times in the other. Repeat with the other leg. You can apply this technique to your swollen hands as well.
Swimming in pool for at least 20 minutes may also help.
Wear comfortable shoes and socks . You can buy socks with specially designed ankle cuffs that won't compress if your feet get a little swollen. Wearing larger, wider, or slip-on shoes can help you feel more comfortable.
Dropsy and preeclampsia during pregnancy
When will swelling disappear?
Try to remember that swelling will not last forever. Like many other discomforts during pregnancy, normal swelling should go away a few weeks after delivery.
If, like some women, you find that you have more swelling after having a baby than during pregnancy, following the same tips and exercises can help you reduce it. It should be gone by the time your baby is six to eight weeks old. Do not forget to be examined in time and visit a gynecologist-endocrinologist during and after pregnancy.