Tearing of the vagina or perineum is a common occurrence during labor. Unfortunately, about 95% of first time births result in a tear. Treatment is usually simple, and there are ways to prevent tears completely.
During labor, everything is trying to loosen and relax. If the baby comes out too quickly, it can result in a tear since there was not enough time for the walls to loosen. There are also other factors at play when it comes to risk for tearing.
Table of Contents
- 5 Types of Tears
- Tear Treatment
- How to Prevent Tear
5 Types of Tears
There are five types of tears that can occur during labor. These five types have different levels of severity. The larger the tear, naturally the more pain you may experience. That of course depends on if you have an epidural, but sometimes even that cannot cover the area completely.
1. Periurethral Tear
Your urethra is where these tears happen. They usually only need some suturing. These often heal very well on their own. Small stitches are usually used so as to not cause urination issues. If there is any concern at all, a catheter may be placed to help your bladder drain.
2. First Degree Tear
Inside the vagina or outside on the perineum is where these tears occur. The first tear is when only the skin is torn. If it is bleeding, it may be stitched up.
3. Second Degree Tear
Both the skin and some muscle are injured with a second degree tear. These tears are common and are repaired with a long dissolvable stitch, just like a first degree tear.
4. Third Degree Tear
The skin, muscle, and part of the external sphincter are affected in a third degree tear. Stool softeners and pain medication may be prescribed to aid with the pain and constipation. Constipation can make healing more painful and disrupt the stitches. Additional stitches are placed to help bring the sphincter back together.
5. Fourth Degree Tear
The deepest and most painful of tears, this extends completely into the rectum. There is a direct passage from the vagina to the rectum. This repair takes much longer, and additional layers of stitches are needed to ensure that the vagina and rectum are separated. Avoiding constipation and pain management are essential for this to heal.
These types of tears most commonly result in stitches. There will be instructions for taking care of these stitches that will be given to you. Doing so will help prevent infection and promote healing.
Caring for Vaginal Tears:
- Squirt warm water over area during and after urinating
- Pat dry with gauze or paper wipes that come with hospital-approved sanitary pads
- Use a new pad, preferably maxi, at least every four to six hours
- Stay regular when it comes to bowel movements
- Let yourself heal
To Reduce Perineal Tear Pain:
Ice will help to ease the swelling and temporarily numb the area.
Your practitioner might suggest an anesthetic to numb the area. These come in many forms such as sprays or ointments.
A warm compress or 20 minute warm sitz bath three times a day can help.
A heat lamp can also work, but check with your doctor first.
Sleep on your side; do not sit or stand for long periods of time.
Doughnut-shaped pillows marketed towards hemorrhoid sufferers can give some comfort.
How to Prevent Tear
There are many things that you can do to help prevent these tears. During your pregnancy you can make decisions and do things that will ease the way for you and your baby.
Pelvic Floor Exercises
Kegels are not only great for overall strength. They can help lessen the complications that may arise during pregnancy. Combining Kegels with squats will help to strengthen your pelvic muscles. Learn to relax your pelvic muscles before labor so you can use the technique while you are giving birth.
Warm water helps to soften tissues and ease crowning sensation. Water births also have many other benefits for you and your baby.
Prepare Your Body
- Your body should be ready to go through the labors of childbirth. Up your exercise routine during your pregnancy to improve circulation and blood flow.
- Nutrition and hydration are critical for muscle health and skin elasticity.
- The best position to use is the one that feels the most natural to you. There are a few positions that put less stress on the perineum.
- On all fours, on hands and knees
- Lying on your side
- Leaning forward while standing, kneeling, or sitting
- If legs are wide apart, it could increase the risk of tearing.
Breathe, Don’t Push
- Holding your breath during contractions not only reduces your oxygen levels, but your baby’s as well. It can also tense your muscles in the wrong way. Breathe down with your contractions and allow your baby to slowly descend and cause less trauma to your pelvic floor.
- The ‘ring of fire’ sensation tells you that you need to slow down and let your body ease into it.
Ensuring that the perineum is prepared before birth is important and has been shown to reduce the risk of tearing, even in first time vaginal births. This can help you learn about your body and gain confidence in your ability to stretch and have your baby.
This is a surgical cut made to the muscle and skin of the perineum to enlarge the vaginal area. This can increase your risk of a larger tear, and should only be done if an assisted birth is needed.
Tearing during labor is a common occurrence. It can be painful and take a few weeks to heal. However, there are many ways to prevent this from happening when you finally deliver your baby.
Five different types of tears can happen, and they all have their own degree of severity. There is treatment, usually stitches, that requires some maintenance but healing should not be too long or difficult.