Postpartum pericare

Elvish, BSN, DNP, RN, NP · May 18, 2011

Honestly, the antibacterial soap/betadine thing sounds like a bit of overkill. We have our pts use the peribottle each time they go to the bathroom, and wash with regular soap and water once daily when they shower, then pat dry. I'm personally a believer in sitz baths for big epis/tears but not many other people use them. We also use the tucks pads and dermoplast spray for tears/hemorrhoids. This was also how it got done at the hospital where my son was born (not the same facility at which I work).

Our c/s patients, once their bandage comes off, we leave the staples OTA and have them wash and pat dry once daily. Pericare is pretty much the same, only we don't usually have to use the dermoplast/tucks unless the section was for an unsuccessful VE (i.e., their bottom is sore).

Dazglue, ADN, BSN, MSN, RN · May 18, 2011

Warm water rinse (peribottle) after using the restroom, dermoplast and tuck pads as needed. Sitz baths are rare.

mkjh · May 18, 2011

One hospital doesn't do any pericare teaching (and also doesn't restrict sex in the postpartum period at all)

The other just does peribottle, and epifoam/tucks as needed.

CompleteUnknown · May 18, 2011

Not an OB nurse but it sounds like overkill to me too. Wouldn't a daily shower with regular soap and a warm water periwash PRN cover this? What's the rationale for the antibacterial soap and betadine? And this is for c-sections too??

When I had my own kids (admittedly it was a while ago lol), the only thing I was advised to do was to shower daily, and peri wash with warm water PRN if feeling uncomfortable. I tore and had stitches with both births.

KareBear0609 · May 18, 2011

Not a nurse, but I will tell you that all I did was (after I went to the bathroom) use the squirt bottle with warm water. If you shower daily, you shouldn't need to do all that extra stuff. I never experienced any problems, never had any infections, etc.

njmomstudent · May 18, 2011

Betadine and antibacterial wipes??? I would think all that would cause even more irritation! I had an episiotomy. Peribottle at every toileting, pat dry, dermoplast for the first few days, and wash as normal during bathing. I also had multilayer thing going on down below.... 2 tucks pads spread over a frozen pantiliner, which laid on top of my big pad. At the hospital they gave us frozen newborn size diapers to wear the first couple of days.... I just continued it afterwards... that ice REALLY helps when the healing itch starts down there from the episiotomy.

NPinWCH · May 18, 2011

We advise warm water peri bottle after using the bathroom, washing in bath or shower once a day and then Tucks/dermaplast/sitz baths if needed. We also offered ice packs for the first 24 hours.

I agree, not only does all the antibacterial stuff sound like overkill I'm pretty sure it would be irritating. Some of the nurses I worked with instructed the patients to add a squirt of antibacterial soap to their peribottle, but I always told the patients not to do that as they weren't advised to rinse it and the soap residue could cause itching.

CoffeeRTC, BSN, RN · May 18, 2011

I've had 5 babies in 3 different hospitals and it was all the same..peri bottle was given and routine. The Dermoplast, hydrocortisone and tucks were given, but I think I had to ask for them once or twice. The sitz bath was given to me at my last hospital but never used. Sooo..cost wise..hold off on the sitz bath unless asked or you assessed the need for one.

Never used abt wash or betadine. I've had C Sections and vbacs.

smily nurse, BSN, RN · May 18, 2011

Wet 3 wipes and put antibacterial soap on them, wipe front to back x1 with each, rinse with peribottle, pat dry. Apply betadine three times a day. This is for vag deliveries as well as c/s's. In addition, the vag's use Dermoplast, hydrocortisone cream, tucks and sitz bath prn.

The betadine is overkill. and I wouldn't want it on my epis.....

The other hospital I work at simply instructs patients to rinse with peri bottle then Dermoplast, tucks and sitz prn. This is what we did @ SMH.... peri bottles are the best!!!Hydrocotisone is also over kill. :yeah:

rn/writer, RN · May 21, 2011

Honestly, the antibacterial soap/betadine thing sounds like a bit of overkill. We have our pts use the peribottle each time they go to the bathroom, and wash with regular soap and water once daily when they shower, then pat dry. I'm personally a believer in sitz baths for big epis/tears but not many other people use them. We also use the tucks pads and dermoplast spray for tears/hemorrhoids. This was also how it got done at the hospital where my son was born (not the same facility at which I work).
Our c/s patients, once their bandage comes off, we leave the staples OTA and have them wash and pat dry once daily. Pericare is pretty much the same, only we don't usually have to use the dermoplast/tucks unless the section was for an unsuccessful VE (i.e., their bottom is sore).

We tell our patients to use peri bottle after toilet use (or during, if stitches sting). Pat dry. Wash peri area with soap and rinse well when showering. We also offer ice pads or ice-filled diapers, Dermoplast, and Tucks pads/ointment as needed. We don't use sitz baths.

IMO, Betadine and antibacterial soap are just not necessary. We hardly every have a mom--vag or section--with a perineal infection.

Elvish, BSN, DNP, RN, NP · May 21, 2011

Oh....and just for clarification...

I don't do sitz baths for infection issues. I just remember they gave me one after my son was born (long 2nd degree tear) and it felt so darn good, I wanted to hug and kiss whoever invented them. So if I see someone struggling with a sore bottom, I show them how to use it and most of them appreciate it.

But it has nothing to do with cleanliness, because we rarely see perineal infections either, and we don't use them much either.