Perineal Tear - Is It Common During A Vaginal Birth

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The journey to childbirth is a wonderful experience for the first-time mother, but there are few unsavory parts to this journey as well. Are you familiar with the term ‘perineal tear’? Do you know when does it occur, and how should you overcome the pain of such a tear? Well, don’t worry if you don’t! MomJunction has you covered.

Here, we have gathered some relevant information about different types of perineal tears, and listed some tips on how to deal with the situation!

What Is A Perineal Tear?

A perineal tear mostly occurs in women having their first vaginal delivery. The tear can be a small nick or a deep laceration. A perineal tear mostly happens when your baby’s head comes out through the vaginal opening. If your child has a large head, it will exert excess pressure on the vagina during delivery, and lead to possible perineal tears.

Tears that involve around your vaginal skin usually heal within a few weeks. But, when the vaginal tear seems to be more extensive, it takes longer to heal. When the pain tends to get excessive and unbearable every day, you need to contact the gynecologist immediately. Excess pain also signifies the onset of vaginal infection, which may require proper treatment.

[ Read: Benefits Of Perineal Massage ]

Types Of Perineal Tear

According to the extent of tearing, Perineal tears are classified as:

1. First-Degree Perineal Tear:

  • They are the mildest vaginal tears, and only involve the tearing of the skin around the vaginal opening or the perineal skin.
  • You may experience a mild irritation or burning sensation while urinating.
  • The first-degree tears usually heal within one week, and may not require any stitches.
  • To overcome the pain during urination, you can take some lukewarm water in a squeezy bottle and pour it into on your vulva. The water soothes the irritation, and you can comfortably pass your urine for the first week after childbirth.

[ Read: Postpartum Rectal Bleeding ]

2. Second-Degree Perineal Tear:

  • The tearing of the perineal muscles, which lies between your vagina and anus, imposes the second-degree vaginal tear. The perineal muscle usually supports our uterus and rectum.
  • 2nd degree tears often require stitches and the damage heals within the first two to three weeks after childbirth.
  • To overcome the pain of second-degree tear, you can follow some of the simple tips. You can try to sit on a pillow or a padded ring to provide additional support to your vagina.
  • You can pour lukewarm water using a squeeze bottle over your vulva while passing your urine.
  • After a bowel movement, try to clean your back portion softly, so that it does not rub against the wounded vaginal region.
  • Apply ice pack to the wounded vaginal region, to overcome the severe pain and irritation. You can also place a chilled witch hazel pad in your sanitary napkin and wear it.
  • Your doctor may prescribe you to intake stool softeners or pain relievers to soothe the unbearable pain of tears.

[ Read: Tips To Deal With Postpartum Perineal Pain ]

3. Third-Degree Perineal Tear:

  • The tearing of the perineal muscles and the delicate muscle around your anus called the anal sphincter imposes 3rd degree tear.
  • Such a perineal tear often gets treated in the operating room, and it may take months to heal.
  • To overcome the severe pain, you can try to sit on a pillow or a padded ring after the delivery.
  • You can pour lukewarm water on your vulva while urinating or place an ice pack on the wounded vaginal region.

4. Fourth-Degree Perineal Tear:

  • It is the most severe form of vaginal tear that involves tearing of the perineal muscles, anal sphincter and the tissue lining of your rectum.
  • 4th degree tear always gets treated in an operating room, and it may take several months to heal.
  • Some of the common complications that can occur are painful intercourse and fecal incontinence.
  • Your gynecologist may evaluate your condition at the postpartum checkup, and may refer you to visit a colorectal surgeon, urogynecologist, or some other medical specialists (1).

[ Read: Recovery After Vaginal Birth ]

Risk Of A Third- Or Fourth-Degree Tear

Here are some of the common situations in which your likelihood to experience third or fourth-degree perineal tear increases:

  • When you have your first vaginal delivery.
  • When your baby is big.
  • When you give birth to your baby lying in a posterior position.
  • When you push your baby for a longer time.
  • When you have an episiotomy or have had one in your previous delivery.
  • When you undergo an assisted delivery that includes the usage of forceps.

[ Read: Precautions After Delivery ]

Tips To Care For A Perineal Tear

When you undergo a perineal tear, the gynecologist often stitches up the vaginal tear and the stitch tends to heal gradually. But, it is important for you to follow certain postpartum perineal hygiene habits, to prevent infection, overcome the pain, and promote healing.

Here are some helpful tips that can keep your perineum healthy and germ-free:

  • Always clean the vaginal area by squirting some lukewarm water on it during and after urinating.
  • After you excrete, try to clean your back using gauze pads or paper wipes. Never rub the skin harshly, as it can increase the risk of infections.
  • Change your sanitary pads after every four to six hours.

[ Read: Assisted Vaginal Delivery ]

  • Take enough rest and avoid touching the wounded perineal region, as it increases the likelihood of infections.
  • Excess straining during excretion can complicate the situation. To regularize your bowel passage intake adequate amount of fluids and fiber-rich foods. Your doctor may also prescribe you a stool softener or mild laxative (2).

Overcoming Perineal Tear Pain

Here are some of the simple tips to help ease perineal tear pain:

  • Try to hold an ice pack on your affected vaginal region, so that it eases the severe pain. You can also try to wear chilled witch hazel pads along with your sanitary napkin to ease the swelling.
  • A warm sitz bath for two to three times a day or warm compress can minimize the pain.

[ Read: Sitz Bath After Birth ]

  • To avoid excess strain, try not to stand or sit for a long time, as it can elevate your perineal pain.
  • You can practice few Kegel exercises and opt for a perineal massage, as it makes your perineal region supple and aids in quick recovery (3)

Did you experience a perineal tear during your childbirth? How did you overcome the pain? Share your experiences with fellow mommies here!

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shreeja pillai

Shreeja holds a postgraduate degree in Chemistry and diploma in Drug Regulatory Affairs. Before joining MomJunction, she worked as a research analyst with a leading multinational pharmaceutical company. Her interest in the field of medical research has developed her passion for writing research-based articles. As a writer, she aims at providing informative articles on health and pharma, especially related to... more