Ramler and Robert did a comparison study of relieving the perineal pain of postpartum women between the cold sitz baths at 15.6-18.3 degrees Celsius first and warm sitz baths at 36.7-44.4 degrees Celsius six hour later. Treatment began during the second 24 hours after delivery and lasted for 20 minutes. The study was done with 40 mothers and it was found that the cold sitz bath could relieve the perineal pain better than the warm sitz bath.13 In addition, Steen and Colleanges studied the comparison between using an icepack, epifoam and maternity gel pack to compress the perineum approximately 4 hours after delivery and found that relieving the perineal pain by those 3 methods were not statistically significant different14 which was consistent with the study by Droegemueller4 indicating that during the first 24 hours after delivery, the cold sitz bath could relieve the perineal pain for 4-6 hours whereas the pain could be temporarily
alleviated by the warm sitz bath. It was also consistent with the study by McCaffery showing that cold compression could relieve the perineal pain faster and longer than hot compression.15 Meanwhile, the study by Sujintana Phankla about alternating the cold compression with the hot compression for mothers 12-18 hours after deliver found that the cold compression could relieve the pain better than the hot one.