A postpartum client at 4 hours post-birth has a painful third-degree perineal laceration. Which intervention should the nurse implement?

• A. Apply cold ice packs to the perineum
• B. Massage the perineal area
• C. Soak in a hot bath immediately
• D. Encourage strenuous activity to reduce stiffness

Answer: (A)

Cold therapy is used after a perineal laceration in the immediate postpartum period to reduce swelling, numb pain, and help prevent a hematoma. Applying cold ice packs to the perineum causes vasoconstriction, which decreases fluid leakage into the tissues and eases discomfort with movement and voiding. In the first 24 hours after birth, this intervention is the most effective way to limit edema and protect the healing tissue, typically used in short cycles (about 15–20 minutes on, with breaks in between). After the initial period, warmth via sitz baths or mild cleaning supports healing, but hot baths are not appropriate right away because heat can increase bleeding and swelling. Massage is avoided in this acute stage since touching or rubbing the fresh repair can disrupt healing, and strenuous activity should be deferred to prevent strain on the perineum.