Perineal tears are common during the birth of a baby. In addition, sometimes the caregiver will cut the perineum to give extra space for the baby to be born (episiotomy). These tears and cuts often cause pain for women in the hours, days and sometimes months after the birth. This can reduce a woman's ability to walk and to sit comfortably, and it may affect her ability to care for her baby, including breastfeeding. Women often use a number of methods to relieve the pain, including cold baths, ice or cold packs on the area. It is important to know if cooling works, and that, even though it is unlikely to occur in this region of the body, too much cooling may possibly delay healing or cause ice burns.
This review looked to see if local cooling for a short period of time helped to relieve perineal pain for women and helped with healing. We found 10 studies including 1825 women that compared cooling treatments such as ice, cold gel pads, or cold bath with no treatment, or other treatments. One study found that women reported less pain 24 to 72 hours after giving birth when they used the ice packs for 10 to 20 minutes, rather than when they had no treatment. No effect on healing was identified.
There is only a small amount of evidence of how safe and effective cooling treatments are to relieve perineal pain.