What is the perineum?

The perineum is the area between the vaginal opening and the anus. During birth, this area stretches under intense pressure. That pressure causes swelling, bruising, and sometimes tearing. Doctors may also make a small cut called an episiotomy.

The majority of women experience perineal trauma during vaginal birth

About 85% of women experience some tearing during vaginal birth.¹ The vast majority are first or second-degree. Third and fourth-degree tears are much less common, affecting around 3% of vaginal births.²

Perineal pain is common after a vaginal birth – whether from a tear, an episiotomy, or just the ordinary swelling that comes from pushing a human into the world.

Understanding the degrees of tearing

Doctors classify tears by depth:²

• First-degree tears: These are small, superficial tears involving only the skin of the perineum. They often heal quickly and may or may not require stitches.
• Second-degree tears: This is the most common type of tear. It involves both the skin and the muscle of the perineal area. Most second-degree tears require stitches and take a few weeks to heal.
• Third-degree tears: These are more significant and extend through the perineal muscles and into the muscle that surrounds the anus (anal sphincter).
• Fourth-degree tears: The most severe type of tear, extending through the anal sphincter and into the lining of the rectum.

The three stages of perineal wound healing

All tears heal through the same three stages.³

• Immediately after birth, your perineum will be significantly swollen, painful, inflamed and red. This inflammatory stage lasts several days, and it is the most critical time for cold therapy to manage that swelling.
• Over the first week, new tissue fills the wound. Collagen strengthens the area. The wound edges naturally pull together and feel less tender as it starts to close.
• From about week three, scar tissue forms and gains strength. Even if it looks healed, the deep tissue remodeling can continue for months. This is why you might still feel occasional tugging or sensitivity even after your external stitches are gone.

Cold therapy is recommended after birth

In a randomised trial of 200 women, average pain scores fell from 6.7 to 2.6 on a 10-point scale within hours of applying a cold gel pad, with measurable improvements in comfort.⁴ A larger 2020 meta-analysis pooling 11 trials and 1,492 participants found cold therapy significantly reduced pain by the second day postpartum, and that ice packs and gel packs worked about equally well.⁵

Clinical guidelines agree on the value of cold therapy, though the recommended timings vary. In the US, ACOG advises applying an ice pack or cold gel pack to the perineal area for 10 to 20 minutes at a time, noting this is most effective in the first 24 to 72 hours after birth.⁶ Health New Zealand advises shorter, less frequent sessions: 5 to 10 minutes, every 4 to 5 hours, over the first 24 hours.⁷ A 2025 European review recommends ice or cold gel packs as a first-line treatment for postpartum pain, and found no adverse effects reported in any of the studies it assessed.⁸

Follow the guidance your own midwife or doctor gives you. Speak to them if perineal pain is not settling or is getting worse, if you need increasing amounts of pain relief, or if you notice swelling, wound breakdown, or discharge with a strong or unpleasant smell.⁹

The PeachCool provides evidence-based relief

Cold therapy works. But not all ice packs are created equal. We designed the PeachCool because frozen peas and stiff plastic ice packs were not good enough.

Medical-grade silicone for gentle, controlled cooling

The PeachCool is made from medical-grade silicone. Silicone transfers cold more slowly than plastic. That matters for healing tissue. It cools the area without shocking sensitive tissue.

Flexibility that moves with you

Our silicone stays soft even when frozen. It molds to your shape instead of poking you with rigid edges.

Most post-natal ice packs use gel beads. Freeze them and they harden, clump and cool unevenly. Parts of your perineum get too cold. Others get nothing. The PeachCool gel stays flexible, so the cold distributes evenly across the whole perineum.

The gel stays even, so the cooling stays even. Every part of your perineum gets the same level of relief.

One-piece molded design

Unlike sealed plastic pouches with sharp edges, the PeachCool is a seamless, single piece of silicone.

When you are dealing with a tear or episiotomy, the last thing you need is sharp seams pressing into your inner thigh.

Designed to fit like a pad

We shaped the PeachCool like a maternity pad so it fits in your underwear. It is sized to provide full coverage to the perineal area without being bulky or intrusive.

Our pad-style design means you can actually sit down or walk comfortably.

Conclusion

Perineal pain is a reality for almost every vaginal birth. You can reduce your discomfort and swelling with targeted cold therapy, gentle hygiene and rest.

The PeachCool is designed to give you steady cold therapy in a shape that fits your body.

References:

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