Vaginal tears during childbirth are an unfortunate, but realistic occurrence during a vaginal delivery. And while not every birthing person experiences perineal tearing, the fact is that tears during birth are relatively common, and can vary in severity. We know that even the thought of vaginal tearing might make you cringe, but it’s a possibility we want to help you prepare for, mama. Here’s what you need to know about the various degrees of tearing during childbirth.
What Is Vaginal Tearing?
Vaginal tearing, also known as perineal lacerations, often happen during childbirth when the baby’s head is delivered. While certainly not always the case, tearing typically occurs as a result of a baby’s head that is too large for the vagina to stretch around, or when the birth occurs so quickly that the skin hasn’t had time to stretch and thin. Assisted birth, such as when forceps or a vacuum are used, can also contribute to tearing.
Vaginal tearing sounds scary (not to mention uncomfortable). But the good news is that many mamas experience only slight tearing that can heal on its own within a few weeks and some don’t experience any at all. No matter what, your provider will do their best to ensure that your delivery experience is as gentle as possible, and will treat any tearing with care. Here are the various levels of tearing a person may experience during the delivery of their baby.
1st Degree Vaginal Tear
This is the least severe type of tear a person can experience during childbirth. First-degree tears only affect the perineal skin, which is the skin between the vaginal opening and the rectum. This type of tear might not require any stitches, and will heal within a few weeks’ time. Women with a first-degree vaginal tear often experience some mild pain as they recover, as well as stinging during urination.
2nd Degree Vaginal Tear
Second degree tears extend deeper into the vagina than a first-degree tear, and affect both the skin and muscle of the perineum. This degree of tear is the most common experienced during childbirth, and typically requires stitches to repair both the muscle and skin. The good news? Your provider can typically repair second-degree tears while you’re enjoying your first moments of skin-to-skin time with your baby!
3rd Degree Vaginal Tear
Third-degree vaginal tears extend into the anal sphincter, which is the muscle that surrounds the anus. These repairs may require general anesthesia in an operating room, and the recovery time can be as long as several weeks.
4th Degree Vaginal Tear
This type of tear is the least common among birthing people. As with a third-degree tear, a fourth-degree tear extends from the vagina into the anal sphincter, but also into the rectum itself. Due to the severity of this type of tear, you will likely be placed under the care of a specialist and repairs must take place in an operating room.
What Can I Expect While Recovering from a Vaginal Tear?
For any type of tear that requires repair, stitches or surgical thread will be used to repair the laceration. These sutures will absorb into the body (typically within six weeks), and don’t require removal when your perineum has healed. The tear itself typically heals within a week to 10 days for less severe vaginal tears. However, you might notice pain and discomfort for a few weeks following. And while there’s no avoiding this situation, we feel it’s our duty to warn you…coughing or sneezing following a tear can be pretty uncomfortable for a week or two.
Can Vaginal Tearing Be Prevented?
While there’s really no way to know for sure whether you will or won’t be at-risk of tearing, there are a few things you can try to lessen your risk. Avoiding tearing during birth mostly has to do with the elasticity of the tissue, your baby’s size and position, and maybe a touch of good luck—but it certainly doesn’t hurt to speak with your provider about trying the following during your delivery:
- Controlled pushing: When possible, slow and controlled pushing can help baby ease out of the vagina in a gentler way, allowing the vaginal tissue and skin more time to stretch.
- Delivering upright: If possible, try to push in a position that isn’t flat on your back. Other positions such as squatting or using a birthing stool may help reduce the risk of tearing.
- Perineal massage: Perineal massage can be done at home near the end of the third trimester, and may also be done by a provider during your second stage of labor. Using a lubricated and gloved hand, a member of your care team may place two fingers just inside the vagina and apply downward pressure while moving from side to side, gently stretching the perineum.
- Using a warm compress: Some recommend placing a warm compress on your perineum during labor in order to help reduce tearing.
How to Find Relief from a Vaginal Tear
It’s important to treat your vaginal tear of any degree with care following birth. Use a peri-bottle filled with warm water to rinse yourself clean after using the bathroom, and gently pat the area dry with toilet paper (try to avoid wiping). We also recommend using a stool softener and drinking plenty of water to help prevent constipation and painful stool as you heal from your tear. Many women also find it helpful to use ice packs and witch hazel wipes (sometimes called “tucks”), which can help with the itching and discomfort that comes along with stitches.
It’s important to discuss any concerns with your provider to ensure you’re healing well after childbirth and a vaginal tear. If you notice any painful swelling, redness, or an unpleasant odor as your tear heals, contact your provider for an evaluation to ensure you don’t have an infection. Whether you’re preparing to give birth, or recovering from a vaginal tear, we want to reassure you that even though this seems scary, your body is capable of AMAZING things, mama.