Witch hazel (Hamamelis virginiana) has astringent, anti-inflammatory properties. It is soothing and cooling and has a mild anti-inflammatory effect on the skin. You can apply it directly to the perineum or try soaking a cloth in cold water, wringing it out thoroughly and putting witch hazel on it before applying to the perineum. Witch hazel is also great for treating varicosities and vulvular bruising and for slowing bleeding. Witch hazel can be used as a compress or a sitz bath.
White oak bark (Quercus robur) has astringent, anti-inflammatory and antiseptic properties. It reduces irritation on the surface of tissues due to a form of numbing. A reduction in surface inflammation is one of the possible effects. A barrier against infection is created which is of great help in wounds and burns. Only a small amount of oak bark is needed in a sitz bath formula; too much can be irritating.
Horse chestnut (Aesculus hippocastanum) contains a compound called aescin that acts as an anti-inflammatory and reduces edema (swelling with fluid) following trauma.(7) Horse chestnut also has astringent properties. Because of the resin content, I would use an alcohol-based tincture. Add 2 teaspoons of tincture to 2–3 cups of warm water. The alcohol in the tincture would be sufficiently diluted so it shouldn't be felt by the woman. Horse chestnut can also be used in a sitz bath or compress.
Horsetail (Equisetum arvense) can be used both internally and topically to decrease inflammation and promote wound healing.(8) It has astringent, diuretic and vulnerary properties. Horsetail also has high silica content, which is helpful in the production and repair of connective tissues and accelerates the healing of broken bones. It can be used as a compress and sitz bath.
Chaparral (Larrea tridentata) has been used topically to decrease inflammation and pain and to promote healing of minor wounds. For topical use, cloths can be soaked in oil preparations or tea of chaparral and applied several times a day (with heat if helpful) over the affected area. Chaparral is a well-known herbal antibiotic. Powdered chaparral can be applied directly to minor wounds after they have been properly cleansed.(9) It can be used as a compress, sitz bath and infused oil. Chaparral should not be used internally.
Using herbs in perineal repair not only promotes healing but gives the mother options and control over her healing process, further empowering her.