A sitz bath involves soaking the pelvic area in warm water, sometimes with added herbs or salts. The term “sitz” comes from German “sitzen,” which translates to “sit” in English. Sitz baths date back centuries and are purported to help with a variety of pelvic health issues. In this post, I’ll focus on sitz baths for postpartum recovery, including proven herbs you can use.
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Understanding Sitz Baths
A sitz bath is a shallow bath that cleanses the perineum (the space between the rectum and the vulva).
Like vaginal steaming, sitz baths are great for postpartum recovery. With both sitz baths and vaginal steaming, herbs act locally on the perineal and pelvic area.
Sitz baths may support perineal and prolapse healing, promote a healthy vaginal microbiome, and have an overall soothing and relaxing effect.
They can also provide relief for pain, burning, or itching in the genital area. Various herbs and salts can be added for a specific effect. You can take a sitz bath in a bathtub, a plastic tub, or with a plastic kit that fits over the toilet.
Typically, a sitz bath involves filling a tub with approximately three to four inches of warm water. The individual then sits in the tub, immersing the hips and buttocks. The bath can be taken as often as necessary, with each session usually lasting around 15 to 20 minutes.
Benefits of Sitz Baths
General Postpartum Recovery
After birth, your body needs healing, rest, and nourishment. A sitz bath can aid postpartum healing, particularly for women who have had a vaginal delivery. The warm water can help soothe and heal the perineal area, reducing swelling and discomfort. Specific herbs can help reduce inflammation, pain, swelling, and burning.
A sitz bath may also help relieve postpartum constipation and hemorrhoids, common issues faced by many new mothers. It’s generally safe to start taking sitz baths as soon as the day after birth, unless advised otherwise by a healthcare provider.
Recovery from Tears and Episiotomies
Sitz baths can help heal tears and episiotomy wounds after birth, according to research. Studies also suggest that sitz baths may also reduce pain and discomfort and provide relief from anal burning, but they don’t seem to impact postoperative pain (Lang et al., 2011; Kushvah et al., 2021).
In several studies, sitz baths reduced pain, redness, and swelling and improved episiotomy wound healing after birth (Khosla, 2017; Kalaivani 2021).
What about water temperature? One study concluded that while both warm and cold sitz baths similarly help relieve post-episiotomy pain, cold baths were more effective in reducing edema (Lafoy & Geden, 1989). On the other hand, cold baths are unlikely to have a relaxing and circulation-promoting effect.
Sadly, no studies looked at the effects of sitz baths on healing after a natural birth with spontaneous tearing. We can assume, though, that sitz baths would have a beneficial effect since natural tears heal much better and cause less pain and discomfort than a cut to the vagina (i.e. an episiotomy).
Help with Pelvic Organ Prolapse
No studies have yet tested the effects of sitz baths on pelvic organ prolapse after birth.
Research on other patient groups is available, though. One study found that sitz baths can help children with pelvic organ prolapse (Richardson et al., 1982).
In another case report, sitz baths helped heal decubitus ulcers and reduce symptoms of fourth-degree uterovaginal prolapse in a 70-year-old woman (Sultana et al., 2023).
Sitz baths are also mentioned as an integral part of Unani, a traditional Indian medicine. Unani medicine mentions sitz baths as a restorative practice, along with cupping, massage, and leech therapy (Riaz et al., 2021).
Although studies on postpartum women are lacking, many women report using sitz baths (along with vaginal steaming) to help heal pelvic organ prolapse after birth.
Since there are no negatives to it and anecdotal reports are positive, it may be worthwhile trying, along with pelvic floor therapy.
Relaxation
Sitz baths may induce relaxation of the internal sphincter muscles and decrease perineal edema. Specific herbs and essential oils used in a sitz bath can also have a relaxing and calming effect (Tejirian et al., 2005).
Plus, just setting the intention and space and making sitz baths a ritual helps de-stress and relax.
Relief from Vaginal Candidiasis & Bacterial Vaginosis
A sitz bath with baking soda may be especially helpful for both vaginal candidiasis and bacterial vaginosis (Secor, 1992).
Herbs that may help with both yeast and bacterial infections can be added to a sitz bath, including St. John’s wort, yarrow, echinacea, chamomile, and calendula.
Relief from Hemorrhoids
Hemorrhoids, which are swollen veins in the lower part of the rectum and anus, can cause discomfort and bleeding. Some women experience hemorrhoids in pregnancy, due to increased blood flow and other factors. For others, this issue may come up postpartum.
A sitz bath can help soothe the area and reduce inflammation, providing relief from the pain and itching associated with hemorrhoids.
In one study of over 500 pregnant women, warm sitz baths with salt three times per day reduced hemorrhoids better than cream. Both groups also took 2g glycerin suppositories and bulk-forming fiber after breakfast as supportive treatment (Shirah et al., 2018).
Warm water increases blood flow to the area and helps relax muscles, which can promote healing and ease discomfort. Some women take a sitz bath after each bowel movement if they feel very sore from hemorrhoids.
Anal Fissure Treatment
An anal fissure is a small tear in the thin, moist tissue that lines the anus. Some women experience anal fissures in pregnancy or postpartum, although they are less common than hemorrhoids. Rarely, a difficult birth may also cause anal fissures (Bužinskienė et al., 2022).
This condition can cause severe pain and bleeding during bowel movements. A sitz bath may help relax the anal sphincter, reducing pain. The warm water can also help clean the area and possibly reduce the risk of infection.
However, the evidence on sitz baths for helping heal anal fissures is mixed.
Overall, some studies suggest that sitz baths provide minor benefits, improve satisfaction, and help reduce pain and burning in people with anal fissures. Other studies indicate no significant effect on pain reduction or acceleration of healing (Nelson et al., 2012; Garg, 2018; Lang et al., 2011; Gupta, 2007; Jensen, 1986; Maestre et al., 2010; Alnassar et al., 2022).
Some people take sitz baths after each bowel movement when dealing with anal fissures to reduce soreness and pain.
Risks and Precautions
While sitz baths are generally safe, there are a few risks and precautions to be aware of. First, the water temperature should be checked before use to prevent burns. The water should be warm, not hot.
Second, overuse of sitz baths can lead to dry, irritated skin. To prevent this, pat the area dry after each bath. You can also apply a gentle, natural moisturizer. Natural oils are also ok, but avoid oils that don’t absorb easily.
Lastly, if you have any health conditions that you’re concerned about, check in with yourself and consult with a healthcare provider before taking sitz baths.
Herbs for Sitz Baths
Adding herbs to a sitz bath can enhance its therapeutic effects. However, it’s important to note that not all herbs are safe for topical use, and some individuals may have allergic reactions. Consult your herbalist if you’re not sure which herbs to use.
Witch Hazel
Witch hazel is a plant that has long been used for its medicinal properties, especially in the postpartum period. When added to a sitz bath, it can help reduce inflammation and soothe irritated skin, making it particularly beneficial for tears and hemorrhoids.
Lavender
Lavender is known for its calming and soothing properties. Adding it to a sitz bath can promote relaxation, reduce stress, and help soothe irritated skin. It can help ease discomfort and promote healing postpartum.
Sitz baths with lavender significantly improved the healing of perineal sutures in one study (Sari et al., 2020).
Calendula
Calendula, also known as marigold, has been used for centuries for its healing properties. When added to a sitz bath, it can help reduce inflammation, promote wound healing, and soothe irritated skin.
Myrth and Frankincense
In one study, myrrh and frankincense sitz baths were more efficient in healing episiotomy wounds than betadine (Faraji et al., 2020).
Yarrow
Yarrow is among the top herbs for skin healing, inflammation, and bacterial or fungal infections. It’s a great addition to sitz baths and vaginal steaming mixtures (Nemeth & Bernath, 2008).
And, it’s a fantastic herb to have on hand since it’s also good for digestive issues, fever, cramping, and menstrual irregularities.
Unani & Chinese Herbal Formulas
Many Chinese and Indian Unani herbs are used in sitz baths.
For example, “Qingre Zaoshi Zhitong” and “Yiqi Fuzheng” formulas were tested in one study. Herbs like rhubarb, dandelion, and angelica are mentioned (He et al., 2022; Du et al., 2023; He et al., 2022)
In Unani medicine, formulations with marshmallow, chamomile, and flax seeds are mentioned (Shaad et al., 2022).
Essential Oils
Various essential oils can be carefully added to sitz baths to aid healing and relaxation.
In one study, postpartum aromatherapy sitz baths were effective in healing the perineum. Essential oils with Lavender, Myrrh, Neroli, Rose, Grapefruit, Mandarin, Orange, and Roman Chamomile were used (Hur & Han, 2004).
Epsom salt sitz bath
Epsom salt sitz baths are almost always a good idea, but they may offer some add-on benefits postpartum.
Epsom salt, also called magnesium sulfate, offers relief by relaxing muscles, reducing inflammation, and relieving pain. It may also help detox the body. While specific research on Epsom salt sitz baths in postpartum care is limited, studies on Epsom salt baths for other conditions show promising results.
Research reveals that Epsom salts may help reduce inflammation and redness while improving skin barrier function. They’re also purported to support detoxification, while the magnesium absorbed from the salts has a systemic beneficial effect (Proksch et al., 2005).
To make an Epsom salt bath, fill a clean tub with warm water, add Epsom salt as instructed, and sit in the water for 15-20 minutes.
Baking soda sitz bath
Baking soda may help with yeast infections and psoriasis. It helps raise the pH level of the skin and mucosa (Chakraborty, 2023).
To make a baking soda sitz bath, add 1/3rd to ½ cup of baking soda to a bathtub (80 liters) of water. Swirl the water until the baking soda is dissolved. Soak your pelvic area for 10 to 15 minutes.
What’s the bottom line?
A sitz bath is a simple, yet effective therapeutic practice that can provide relief both during pregnancy and after birth.
Although the research on sitz baths is limited, most studies support their use for common pregnancy and postpartum issues.
Whether you’re dealing with hemorrhoids, prolapse, or simply seeking to relax, a sitz bath can be a great addition to your self-care routine.
The founder of Herbal Doula.
Home-birthing mama, independent scientist, natural pharmacist, doula, birthkeeper, and holistic health and birthrights advocate. Endlessly passionate about creating and sharing empowering health information and birth support. Ana has written 150+ and edited 800+ articles, some of which reached over 1 million people
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