A vaginal tear (perineal laceration) is an injury to the tissue around your vagina and rectum that can happen during childbirth. There are four grades of tear that can happen, with a fourth-degree tear being the most severe. An episiotomy is a procedure that may be used to widen the vaginal opening in a controlled way.
Symptoms
A vaginal tear can happen during childbirth. Also called a perineal laceration, this is a tear in the tissue (skin and muscle) around your vagina and perineum. The perineal area (also called the perineum) is the space between the vaginal opening and your anus.
During a typical vaginal delivery, the skin of your vagina prepares for childbirth by thinning out. This part of your body is meant to stretch and allow the baby’s head and body to pass through without trauma. However, there are several reasons why a vaginal tear might happen. These reasons can include:
- A large baby.
- A very quick delivery (the skin hasn’t had time to stretch and thin).
- Use of forceps during delivery.
Causes
A vaginal tear during childbirth can happen for a variety of reasons. A few factors that could cause a tear can include:
- If it’s your first delivery.
- The position of the baby (face-up deliveries).
- Use of forceps or a vacuum during delivery.
- A large baby (more than 8 pounds).
- If you’ve had an episiotomy.
- If you are of Asian ethnicity.
Treatment
Treatment of a vaginal tear depends on the severity of the injury. In a first-degree tear, you may not need any stitches. In a second-, third- and fourth-degree tear, you will receive stitches to repair the injury. Any stitches will dissolve on their own within six weeks. In some of the most severe cases, your healthcare provider may need to repair the injury to the anal sphincter. This will also be done with dissolvable stitches. You may feel some discomfort in the weeks after delivery while your tear heals. There are a few things you can do to help ease this discomfort. These tips work with each type of tear.
- Use a peri-bottle (a squirt bottle) to wash yourself clean after using the bathroom.
- Gently pat yourself dry with toilet paper instead of wiping.
- Avoid constipation by drinking plenty of water and using a stool softener.
Your healthcare provider may also give you cooling pads to wear with your sanitary pad post-delivery. These can help relieve discomfort from your tear. Make sure you check with your healthcare provider before taking any pain relief medications. What medicines you can and can’t have may change if you are breastfeeding.
