Giving birth to your baby is one of the most profound experiences you will ever go through. However, there are some physical aspects that aren’t so wonderful and one of these is vaginal tearing, an almost certain consequence of first-time deliveries, affecting up to 95 percent of first-time mothers.
What exactly is a vaginal tear?
A vaginal tear is a spontaneous laceration to the perineum, the area between your vagina and anus. It occurs when the baby’s head is coming through the vaginal opening and is due to the vagina not being able to stretch around the head. There are four degrees of vaginal tearing:
- A first-degree tear is the least severe type of tear and only involves the skin around the vaginal opening or perineal skin. These tears aren’t severely painful although you may experience some stinging or mild burning while urinating.
- Second-degree tears involve the perineal muscles, which are the muscles between the vagina and anus that help support the rectum, uterus, and bladder. Second-degree tears usually need stiches and begin to heal within a few weeks.
- Third-degree tears involve both the perineal muscles as well as the muscle that surrounds the anus (anal sphincter). These tears may require repair in an operating room and can take up to a few months to heal. Complications such as painful intercourse or fecal incontinence may occur.
- Fourth-degree tears are the most severe and thankfully the least common type of tear. In addition to involving the perineal muscles and anal sphincter, they also involve the tissue lining the rectum. Fourth-degree tears usually require surgery and like third-degree tears may take months to heal and may also result in painful intercourse or fecal incontinence. At your postpartum check-up, your healthcare provider might refer you to a colorectal surgeon, urogynecologist or another specialist.1
Is there any way I can prevent tearing during childbirth?
There are some things you can do during labor that may help reduce the severity of tearing. These are:
- Pushing the baby out slowly and gently – this can allow your tissue time to stretch and give way for the baby. Breathing exercises can help you achieve this, such as exhale pushing. In this exercise you slowly breathe in and slowly exhale. When the baby’s head is crowning, you could switch to using short almost grunting pushes.
- Using a lubricant – applying a lubricant such as warmed mineral oil can reduce friction and help the baby slide out.
- Keeping your perineum warm – placing a warm cloth on your perineum increases the blood flow and softens the muscles.
- Pushing and delivering on your side – this can help decrease any excessive perineal stretching.2
Steps you can take to ease your discomfort
There are several measures you can take after the birth to reduce the pain from tearing. These include:
- Sitting on a pillow or padded ring
- Pouring warm water over your vulva during urination and rinse yourself with a squeeze bottle afterwards
- Pushing a clean pad against the wound when passing a bowel movement
- Cooling the wound with an icepack
- Taking stool softeners or pain relievers as recommended1