Vaginal Tearing During Childbirth

Approximately 90 percent of women experience vaginal tearing, or perineal tearing, during childbirth. Perineal tearing occurs when the area between the vagina and the anus (the perineum) tears as a result of a natural delivery. Some tears heal on their own while more severe wounds may require stitches. Typically, tears heal within seven to 10 days with appropriate care and treatment, though the pain can persist for much longer for some.

Degrees of Tearing

There are five degrees of perineal tearing, four of which occur naturally and one that is purposeful. Below are the following five degrees of tearing:

Episiotomy occurs when the OB/GYN makes an incision to help with the delivery.
Superficial tears involve the skin around the perineum and the tissue around the outside of the vagina. These types of tears may or may not require stitches.
Second-degree lacerations involve the muscles and need to be stitched closed layer by layer.
Third-degree tears involve the vaginal tissue, perineal skin and perineal muscles that go down to the muscles that surround the anus (anal sphincter).
Fourth-degree tears go through the sphincter and to the tissue beneath it.

Many doctors offer episiotomies to help prevent more severe tears, but the truth is that these procedures often increase a person’s risk of serious lacerations. Unfortunately, if you present risk factors for tearing, there isn’t much you can do to prevent it. That said, you can make recovery easier on yourself.

Recovery Dos and Don’ts

There are measures you can take, and activities and products you can avoid, to help make your recovery as comfortable as possible.

Recovery Dos

Once you come home with your baby, try to apply ice to the affected area for 10 to 20 minutes at a time to help reduce swelling
If your doctor prescribes stool softeners, use them to reduce strain during bowel movements
Keep your perineal area clean and moist after delivery—your doctor may give you a squeeze bottle to help make cleansing the area easier
If possible, get plenty of rest

Recovery Don’ts

DON’T use bath salts
DON’T apply hot water or heat packs to your perineal area
DON’T engage in sexual activity
DON’T use tampons
DON’T use vaginal cleansers or douches
DON’T use scented products on or around the perineal area

Timeframe for Recovery

If you adhere to the advice above, the wound itself will heal in a few short weeks. However, depending on the severity of your tear, you may experience discomfort or pain for several months. While ongoing pain and discomfort are normal, certain signs indicate a more serious problem. If you notice symptoms of infection, intense pain while urinating, frequent urination, trouble controlling your bowel movements, extreme loss of blood, or intense pain in your lower abdomen, perineum, or vagina, contact your doctor right away.

Vaginal tears are a normal part of childbirth, but that doesn’t make them any easier to deal with. Talk to your doctor about what to expect and the outlook for this common labor and delivery complication.