I am 10 days postpartum with a second-de

I'll start by reading the relevant clinical cards.

Call your midwife, GP or maternity unit today about the pain that is getting worse — on day 10 a second-degree tear is still healing, but pain that is *increasing* rather than easing is exactly what they ask to hear about, and it is a same-day phone call, not an emergency visit. You do not have to be in danger for this one to be worth making.

I am not diagnosing you and I am not changing anything you take. Everything below is home comfort while you wait for that call, plus what would make you go instead.

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1) What you already tried → the better version of the same thing

Pushing hard on the toilet → this is the one to stop doing. Straining pushes strain onto fresh stitches.

• Keep passing stool soft. Whatever softener or laxative was prescribed to you, keep taking it as prescribed — do not increase it, double it, or borrow anyone else's.
• Add what you already have at home: water through the day, and fibre foods already in your kitchen (oats, lentils, beans, cooked vegetables, whole fruit with the peel). If a food usually upsets you, leave it out.
• The NHS page says that if passing stool is particularly painful, taking laxatives can help because they make stool softer and easier to pass — that is why this is not a willpower problem.

"Nerve" about cleaning the area → the fear is the problem, not the cleaning. Make it smaller and mechanical so you never have to decide mid-pain.

• Your peri bottle is the right tool: fill with warm (not hot) water, use it after every toilet trip, and let the water do the work instead of wiping hard.
• Wiping: gentle, front to back, pat dry. Never scrub, never wipe back-to-front.
• Never put anything into the vagina — no internal washing, no "cleaning" between the stitches.

Cold packs → keep going, with one change: wrap it in a towel first. NHS says to try an ice pack or ice cubes wrapped in a towel on the cut, and to avoid placing ice directly on the skin as it can cause damage. 10–15 minutes at a time, then off.

Sitz baths → keep, but lukewarm, not hot, and dry the area properly afterwards. Warm water over the area while you pee also eases the sting — you can do that standing over the peri bottle, no clothing juggling.

One addition that costs 10 minutes a day: lie on a clean towel with no underwear on for about 10 minutes, once or twice a day. The NHS page says exposing the stitches to fresh air can help healing. That is also your one guaranteed quiet block — use it while the baby naps.

For the toilet itself: a clean pad pressed gently against the cut while you pass stool takes the pressure off. For peeing, squatting over the toilet instead of sitting often stings less.

She already feels sore. That is normal at 10 days. What is not normal is pain getting *worse* instead of better — which is the reason for the call today, not a reason to panic.

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2) Constraints / what to avoid

• Do not start, stop or change any medicine — including the stool softener, any painkiller, or anything left over from pregnancy. Prescribed means prescribed to *you* by a prescriber.
• No powders, herbal washes, antiseptic mixes, boric-type products, or anything bought online without a prescription. Nothing from a neighbour's cupboard.
• No douching or putting anything inside the vagina.
• No ice directly on skin.
• Do not push, strain or "bear down" on the toilet, and don't sit on the loo reading — go in, soften, out.
• Do not have penetrative sex while it hurts, and don't put off contraception afterwards: the NHS page notes you can get pregnant as early as 3 weeks after birth, even while breastfeeding.
• Pain relief is a decision, not a guess. The NHS page says paracetamol is generally considered safe while breastfeeding, and that ibuprofen is thought to be safe but should be checked with your doctor first; stronger prescription options exist for severe pain and your midwife or GP can advise. Bring this to the call rather than deciding alone tonight — I am not putting a number on any of it.
• You are not alone in the calendar: whoever is on school-run duty can take the "bottle, wipe, cold pack" role completely for the next 48 hours. That is a legitimate handover, not a favour.

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3) Decision tree

Any one of these → call your local emergency number now, or go to the maternity unit / emergency department, do not wait for office hours:

• Foul-smelling discharge, or pus-like or green/yellow discharge from the cut
• Fever, chills/shivering, or feeling too weak to get out of bed
• Pain getting sharply worse hour by hour, or the skin around the tear hot, spreading red or swelling
• Bleeding that is heavy or *increasing* rather than settling, or more than 2–3 pads soaked in 20–30 minutes
• Severe abdominal/belly pain
• Fast or difficult breathing, chest pain, or pain/redness/swelling in one calf
• Severe headache with blurred vision, or swelling suddenly in face or hands
• Feeling unsafe, frightened of your own thoughts, or thinking about harming yourself or the baby — do not be left alone with the baby; call for help and stay with someone

None of the above, but pain is increasing or you are frightened to look → call today (midwife / GP / maternity unit, whoever your local door is). Tell them: *10 days post-birth, second-degree tear, stitches, pain increasing over the last day or two, no fever.* Ask them to look at the site.

None of the above and pain is flat or easing → keep the routine above, and still raise it at your postnatal check. NHS notes that pain lasting longer than 2–3 weeks is unusual and worth raising with a professional, and that stitches generally heal within about a month of birth. Skin-part healing is usually a few weeks; everyone is different, and that's a range, not a promise.

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What "better in 24 hours" looks like — not a cure

Not "no pain". Concretely, by tomorrow evening:

• You can reach for the peri bottle without dreading it, and the rinse takes under a minute.
• Sitting on the edge of the sofa is a choice again, not a negotiation.
• The last stool passage was not a straining event.
• You made the one phone call you were avoiding, and you know your door is open if you need it.

Those four are enough for day 10. Slow healing at this stage is common and is not a setback.

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The one question that changes tonight

Do you have any fever, any smelly or coloured discharge, or spreading redness/swelling around the tear right now? Yes to any of those moves you up the tree immediately. Everything else on this page still stands.

I could not see the area — I'm going on what you've told me, and a mirror check (NHS says you can use a mirror to look) is worth doing before you call, so you can describe it accurately to the person who examines you.

Where to go: your midwife, GP/family doctor, or the maternity unit that delivered you. Which country or city are you in? Tell me and I'll name the local door and its official hours rather than guess.

*Source for the care and timeline above: NHS, "Episiotomy and perineal tears" (nhs.uk), checked 18 October 2026 — "Stitches should heal within 1 month of the birth"; "It's unusual for pain after an episiotomy to last longer than 2 to 3 weeks"; "you may find it useful to place a clean pad on the cut and press gently"; "Taking off your underwear and lying on a towel on your bed for around 10 minutes once or twice a day may help"; "place an ice pack or ice cubes wrapped in a towel… Avoid placing ice directly on your skin"; "your stitches get more painful… there's smelly discharge… there's red, swollen skin". Danger-sign list: WHO Pocket book of hospital care for mothers.*