Perineal Tears

This guest blog post is by Izzy at Izzy Living. She’s a herbalist and a nutritional therapist with an interest in helping women.

She was one of my clients for a while and in our sessions she would talk about the wonders of herbs and how they could help with all sorts. It’s especially handy in pregnancy when pretty much the only medical thing you’re able to have is paracetamol.

In this post, she talks about perineal tears, so I’ll leave you to read on, plus I’ll include her contact details at the end should you have any further questions.

A common occurrence in childbirth is perineal tearing.   As you can imagine, our poor perineum needs to stretch and flex beyond the usual limits to allow for the baby to be born!

And in some women, understandably the perineum will tear during this process or sometimes the perineum will be deliberately cut (an episiotomy) to facilitate the baby coming out!

There are different degrees of tears graded from a small skin-deep tear to one that extends into the rectum.

Unfortunately, repairing a tear can take time and cause significant discomfort. The long-term effects sometimes can include bowel urgency or difficulty controlling bowel movements.

Fortunately, though once the area has healed there are lots of different exercises that can strengthen the anal area and pelvic floor to prevent incontinence!I’ll leave that side for Em to take care of! 

Instead, I shall share with you some simple and safe ways to help with the healing of a perineal tear.

Firstly, if you are pregnant then there are a few tricks from the midwives that have been shown to lower the rates of tearing.

Prevention is always better than cure so let’s start here:

  • Massaging the perineum throughout the pregnancy with something like olive oil can help bring flexibility to this important area.
  • Massage during the birth as well as the application of hot compresses may also help.
  • Breathing with urges to push rather than bearing down to push.
  • Trying alternative positions such as squatting, standing, lying on the side may reduce tearing.

If you do experience tearing, then do not worry.  It is very common and there are natural things that you could try to speed up the healing process.

Plants were typically used by midwives and so we have a strong tradition of using herbs for healing post partum.

There is even a specific category of herbs called ‘astringents’ that restore tone to the tissue, promote healing and protect from infection. Witch hazel bark is an astringent herb that you might already be familiar with!

Witch hazel which can be applied using a peri-wash or a sitz bath (see below for instructions). 

However, there are lots of other herbs you could also try such as: 

  • Yarrow (Achillea millefolium)You can find this common weed in any park or field. It is used externally to heal wounds and stop bleeding. Traditionally, known as woundwort, yarrow has a long history of dealing with injuries from the Ancient Romans who would use yarrow for cuts and wounds to soldiers using it on the battlefield as recently as World War I.
  • Calendula also known as Marigold (Calendula officinalis)Calendula is another first aid hero that is excellent for skin healing. Calendula is an anti-inflammatory and wound healer. It also has anti-microbial and anti-fungal activity that can prevent infections.
  • Lavender (Lavendula officinalis) – This popular plant has been studied and shown to be effective for relieving pain and healing in women post partum. Lavender is mildly analgesic and antiseptic, and of course, very calming!
  • Sage (Salvia officinalis) – Sage is lovely garden herb that can speed the healing of wounds. You can add it to the bath or make a compress by soaking some material in sage tea and applying it to the affected area. Drinking sage tea can also dry up breast milk when you are ready to stop breast feeding.
  • Rosemary (Rosmarinus officinalis)Rosemary is typically associated with improving memory and digestion. However, used topically rosemary is rich in antioxidants and is antibacterial and anti-fungal. It has been studied to speed up wound healing and is highly anti-inflammatory to relieve redness and pain. 
  • Comfrey (Symphytum officinalis) – Also known as knitbone, comfrey is adept at healing and knitting tissues back together. You will be amazed at how quickly it speeds skin repair.  You can make or buy comfrey oil which can be massaged into the skin for suppleness and elasticity.  

Aviva Romm in her wonderful book Botanical Medicine for Women’s Health shares this recipe for a herbal bath for when there is tearing, bruising, abrasions or soreness.

I have adapted the quantities slightly and you can experiment with different herbs. 


  • 10g Comfrey leaf
  • 10g Yarrow flower and leaf
  • 10g Sage leaf
  • 10g Rosemary leaf
  • 1 large fresh bulb of garlic
  • 100g sea salt


  • Peel the garlic cloves and blend in 500ml of lukewarm water. Blend until a milky liquid is obtained and the garlic is pulverised. Strain this liquid.
  • Bring 1.5 litres of water to boil and add the different dried herbs then steep for 30 minutes. Strain this and discard the herbs.
  • Combine half the garlic milk and half the herbal infusion along with 100g of sea salt to a bath. 
  • You can use the remaining liquid for another bath.

There are many places you can source dried herbs from to make your own sitz bath or peri-wash. However, I love that you can get rosemary or sage from the supermarket so these are very accessible herbs if you are new to herbal medicine.Th

This is a general guideline recipe you can use for the herbs you want to work with.

How to make a herbal sitz bath for perineal tears:

  • Use 50g of dried herb for every litre of water 
  • Simmer in a pan for 15-30 minutes (flowers and leaves can be simmered for a shorter time than barks or roots)
  • Strain off the herbs and pour the water into a shallow basin or pan that you can submerge the perineum in.
  • Sit for 15 minutes once a day if you have stitches or more often if you don’t.

Izzy is a naturopath who specialises in herbal medicine and nutrition to help people feel better using natural medicine.

If you want to know more about women’s health and herbal medicine, you can either follow her on instagram or head to her website


Author empointer

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