What is Vaginal Tearing?
Vaginal tearing is a laceration of the skin and tissues of the vagina, vulva, or perineum (the area between the anus and vulva). It can range from a small first-degree tear to a large fourth-degree tear.
First-degree tears are superficial lacerations that involve only the skin. They don't usually require stitches and will heal on their own within a week or two.
Second-degree tears are deeper lacerations that go through the skin and into the muscle tissue beneath. They may require stitches and will take longer to heal, typically four to six weeks.
Third-degree tears are the most severe type of vaginal tear. They extend from the skin all the way through the muscle tissue to the anal sphincter (the muscle that controls bowel movements). These types of tears usually require surgery to repair and can take several months to heal completely.
Fourth-degree tears are the most severe type of vaginal tear. They extend from the skin all the way through the muscle tissue to the anal sphincter and involve damage to the rectum or other nearby organs. These types of tears usually require surgery to repair and can take several months to heal completely.
Why Does Vaginal Tearing Occur?
The majority of vaginal tearing occurs during childbirth as the baby's head passes through the birth canal. The perineum (the area between the anus and vulva) is particularly susceptible to tearing because it doesn't have much elasticity. Episiotomies (a surgical incision made in the perineum to enlarge the birth canal) can also contribute to vaginal tearing.
How Can I Prevent Vaginal Tearing?
There are a few things you can do during childbirth to help prevent vaginal tearing:
• Use perineal massage during pregnancy: Massaging the perineum with lubricant starting at 34 weeks gestation can help increase elasticity and make it more likely to stretch instead of tear during childbirth.
• Opt for continuous support: Having a doula or other support person with you during labor has been shown to reduce your risk of episiotomy and severe tearing by up to 50%.
• Try different positions: Pushing in different positions (squatting, hands-and-knees, side-lying) can help avoid excessive stretching of the perineum.
• Don't hold back: If you feel like you need to poop, go for it! Pushing while constipated can put unnecessary strain on your perineum.
• Take your time: Allow your baby's head to crown (slowly emerge) before pushing hard with each contraction. This gives your perineum time to stretch gradually instead of being forced open too quickly.
Vaginal tearing is a common occurrence during childbirth, but that doesn't mean it's any less painful or stressful when it happens. Luckily, there are things you can do both during pregnancy and during labor to help prevent it from happening in the first place. And if you do end up with a tear, know that they're typically not as bad as they look—and most importantly, that they will heal!