What a perineal suture is and why it is done
A perineal suture repairs tissue that tore during childbirth or was deliberately opened. The aim is to stop bleeding, support healing and restore anatomy so function and strength return.
This can happen after a perineal tear, after an episiotomy, or after other small childbirth-related injuries around the vaginal opening. Many sutures are made with absorbable stitches that break down over time.
Professional obstetric guidance explains perineal tears and episiotomy and emphasises that healing takes time and symptoms should be taken seriously. Perineal tears during childbirth — further information
How healing can typically feel
Healing is not linear. In the first days it is mainly wound pain, swelling and a feeling that everything is very sensitive. After that many people slowly improve, but individual days can feel worse again — for example after long periods of sitting, too little sleep or difficult bowel movements.
Common, plausible sensations
- Burning or pulling when standing up, sitting down or when passing urine
- A feeling of pressure, especially after prolonged sitting
- Brief sharp twinges at specific points when a stitch end rubs
- A firm scar feeling or small nodules in the tissue during remodelling
If symptoms generally improve week by week, that is often a good sign. If things worsen, it is a signal to take a closer look.
Stitches that prick: what may be behind it
Pricking stitches are common. Often a stitch end protrudes slightly or the mucosa is so sensitive that any contact feels like a stab. Dry mucous membranes can also increase friction, especially if you are breastfeeding.
It is important to distinguish: occasional pricking is different from persistent, worsening pain or a feeling that something is tearing open. If you are unsure, a quick check at the clinic is often the fastest reassurance.
What you can usually do if stitches are prickling
- Reduce friction, for example with soft underwear and loose clothing
- Relieve pressure when sitting, with a cushion or lying on your side
- Keep the wound clean and dry, without aggressive scrubbing
- If symptoms are severe, have it checked rather than pulling at the stitch yourself
Daily care: less is often more
The best care is usually simple. The body heals when the environment is calm. Many products feel active but can irritate, dry out or disturb the skin barrier.
Practical care that is often well tolerated
- Clean gently, preferably with water, then pat dry instead of rubbing
- Change pads regularly so the area is not constantly damp
- Apply short periods of cooling for swelling, but not directly on bare skin and not for too long
- Allow air to the area when possible in daily life
If you want to use something additional, the key question is whether it really soothes or makes the area more noticeable. When in doubt, check with your midwife, clinic or pharmacy.
Pain when sitting: why this can last so long
Sitting places direct pressure on the area that is currently remodelling. Many people also unconsciously tighten up in the first weeks because they expect pain. The pelvic floor and gluteal muscles then hold tight, which produces even more pressure.
It helps to dose activity rather than avoid it. Short sitting periods, frequent position changes and a soft cushion are often more effective than hours of protective behaviour that leave you in constant tension.
Everyday strategies that relieve many people
- Get up by rolling to the side rather than straight up
- When sitting, lean slightly forward or take weight off to one side
- Lie down briefly several times a day so pressure is relieved downward
- Avoid straining on the toilet, as that puts strong pressure on the perineal area
Bowel movements and the perineal suture: an underestimated factor
Hard stools and straining are for many the moment when everything feels worse again. This is not because you did something wrong, but because pressure and friction can irritate the wound.
In this phase it can be sensible to actively aim for soft stools, for example through adequate fluid intake, fibre and a calm routine without time pressure. Fear of bowel movements is common in the postpartum period, but it can become a cycle of tension and constipation.
Warning signs of infection or impaired healing
Many worries revolve around whether the suture is infected. The most important signals are not a single twinge but a clear deterioration or a combination of several signs.
Have it checked if
- Pain increases markedly instead of slowly decreasing
- A strong, new smell or purulent discharge appears
- The area looks clearly red, hot or very swollen
- Fever, chills or a strong feeling of being unwell occur
- The suture visibly opens or you feel tissue is coming apart
If you have severe headache, visual disturbances or shortness of breath, these are not typical for a local suture infection but are still reasons for prompt assessment in the postpartum period.
Later scar sensations: when everything is healed but it still feels wrong
Sometimes the wound is technically closed but the tissue feels firm, numb or oversensitive. This can be related to nerve healing, scar adhesion or pelvic floor tension. Many notice it when sitting, when returning to exercise or during sex.
In those cases simple care often no longer helps; targeted support is useful. Pelvic floor physiotherapy can assess whether the issue is muscle tension, scar mobility or coordination. If breastfeeding contributes, dryness can add to the irritation.
Major obstetric organisations note that the period after birth is a longer process of adjustment and that symptoms should be taken seriously even if they are not acutely dangerous. Postpartum recovery — further information
Hygiene, tests and safety
The perineal area is sensitive in the postpartum period. That does not mean you must live sterilely. It means avoiding anything that causes additional irritation.
What is usually sensible in this phase
- No aggressive intimate washes or fragrances
- Do not use tampons until bleeding has stopped and you have medical clearance
- If you use a bidet or a shower, use a gentle stream rather than a strong jet
- With noticeable symptoms, it is better to have an early check-up
For general orientation on the time after birth and physical recovery, government health services provide a good overview. Post-birth recovery overview
When medical advice is particularly sensible
If something does not improve, that is not automatically normal. It is a sign that you need support. Many problems can be solved quickly if they are looked at early, for example stitch irritation, a small wound opening or early infection.
Good reasons to get checked
- Pain becomes markedly worse after an initial improvement
- Stitches prick so much that sitting and walking are barely possible
- Smell, discharge, fever or a strong feeling of being unwell accompany the wound
- After several weeks you still have strong scar pulling or burning
- Sex or a tampon trial is clearly painful later on, even though you waited
If you want to go deeper into what perineal injuries are and what follow-up care can look like, professional obstetric guidance is a clear source. Perineal tears during childbirth — further information
Conclusion
A perineal suture can prick, burn and irritate when sitting in the postpartum period without meaning something is seriously wrong. Sensible care is usually simple: clean gently, keep dry, reduce pressure and avoid straining. The main warning signs are a clear deterioration, fever, bad smell, strong redness or a suture that opens. If you are unsure or the course does not improve, an early check is often the quickest route back to reassurance.
