Vaginal tearing refers to small or large tears in the vaginal tissues, often occurring during childbirth. It is a common occurrence during vaginal deliveries, especially for first-time mothers or when the baby’s head is larger than the vaginal opening. Vaginal tears can range from minor superficial tears to more significant tears involving deeper tissues.
More than 9 in 10 women experience tearing during their first vaginal birth. Vaginal tears are extremely common, and it’s normal to have questions about what it means and what to do if it happens to you.
Degrees of vaginal tearing
All vaginal tears involve the perineum, which is the area between your vagina and anus. Tears range in severity, and doctors classify them into four degrees:
First-degree tear
First-degree tears are the smallest, and affect only the skin around the outside of your vagina or just inside it. We may place a few stitches to ensure you heal properly, but many women find that first-degree tears heal on their own within a few weeks.
Second-degree tear
Second-degree tears are deeper, and involve the muscles of your vagina and pelvic floor. If you have a second-degree tear, we use stitches to close the laceration. These tears are more painful, and typically take a few weeks to fully heal.
Third-degree tear
Third-degree tears affect the skin and muscle from your vagina to your anus, and may cause damage to your anal sphincter muscles. You need stitches for third-degree tears, and recovery takes several weeks to a month or two.
Fourth-degree tear
Fourth-degree tears are the least common type of tear, but the most severe. These tears go from your vagina, through the perineum and anal sphincter, and into your rectum. You need stitches, and pain may last for several months.
Caring for a vaginal tear
If you tear during childbirth, our team diagnoses the laceration and uses stitches if needed. We inform you of the injury and give you instructions for caring for yourself after birth.
All degrees of tears can be painful, but the severity of your symptoms and how you care for your injury depends on the type of tear you have.
First- and second-degree tears cause pain or discomfort for about 1-2 weeks. Use a peri-bottle to wash and pat the area dry instead of wiping. Consider using sitz baths or cooling pads to manage pain. If you have stitches, they will dissolve on their own.
Third- and fourth-degree tears take longer to heal and require extra care.
More severe tears can increase your risk of longer-term complications like pelvic floor dysfunction, incontinence, and pain with sex.
Management and Care:
- Immediate Postpartum Care: After childbirth, the healthcare provider will assess the extent of tearing and provide appropriate care, including suturing if necessary. Anesthesia may be used to minimize pain during the procedure.
- Pain Management: Over-the-counter pain relievers or prescribed medications can help manage pain and discomfort during the healing process.
- Keeping the Area Clean: Gently clean the perineal area with warm water and mild soap after using the bathroom. Pat dry with a clean towel or use a peri-bottle for gentle cleansing.
- Sitz Baths: Taking warm sitz baths a few times a day can promote healing and provide relief.
- Kegel Exercises: Once approved by the healthcare provider, Kegel exercises can help strengthen pelvic floor muscles and aid in healing.
- Avoiding Straining: Avoid constipation or straining during bowel movements by maintaining a fiber-rich diet and staying hydrated.
- Avoiding Sexual Activity: Sexual activity should be avoided until healing is complete and approved by the healthcare provider.
- Follow-Up Care: Attend follow-up appointments with the healthcare provider to monitor healing progress and address any concerns.
Healing time varies depending on the extent of the tear, but most vaginal tears heal within a few weeks to a couple of months. It is essential to follow the healthcare provider’s instructions for proper care and recovery. If there are signs of infection, excessive pain, or any other concerns, seek medical attention promptly.
