A vaginal tear is an injury to the tissue around the vagina and rectum. It is also called a perineal laceration, and it often occurs during childbirth.
Between
This article discusses what a vaginal tear is, the different degrees of tears, what to expect from recovery, and more.
When vaginal tears occur during childbirth, they often happen because the baby’s head or shoulders are too large to pass through the vaginal opening. This type of tear can also occur when the delivery is assisted by a vacuum or forceps.
A vaginal tear can also happen as the result of an episiotomy. This is a surgical procedure. It involves making an incision to widen the opening and facilitate the delivery.
Certain factors raise the risk of tearing during childbirth. These
- the size of the baby
- a prolonged second stage of labor
- induced labor
- the baby being in the occiput posterior position, with the back of the baby’s skull resting against the back of the pregnant person’s pelvis
- first delivery
- being of
Asian descent
When the baby is in the occiput posterior position, it can have trouble tucking its head in. This makes it harder for the baby to pass through the smaller part of the pelvis. It can lead to tearing during delivery.
Outside of childbirth, vaginal tears can also occur from penetrative sex and pubic hair removal.
There are four degrees of vaginal tears. The amount and type of tissue that is injured determines the degree of the tear.
First-degree tears
First-degree tears
Second-degree tears
Second-degree tears are more serious than first-degree tears. They affect the moist vaginal tissue and the perineal muscles, but not the muscles around the anus. Second-degree tears
A 2020 study found that among 644 women, second-degree tears occurred in
Third-degree tears
Third-degree tears affect vaginal tissue, perineal muscles, and muscles of the anal sphincter. These muscles surround the rectum and help a person pass bowel movements.
Injuries to the anal sphincter may occur in up to
Below are the
- A: The tear goes through less than 50% of the anal sphincter.
- B: The tear goes through more than 50% of the anal sphincter.
- C: The tear goes through both the external and internal anal sphincters.
Third-degree tears happen far less often than second-degree tears. In the same study from 2020, researchers found that
Fourth-degree tears
This is the most serious degree of vaginal tear. It extends further through the sphincter muscles into the lining of the rectum.
This type of tear happens rarely. The 2020 study found that it affected
Doctors can repair most vaginal tears by administering stitches in the delivery room after birth. A doctor will numb the area with a local anesthetic before beginning the repair.
While stitches are a common approach, there is
First-degree tears and some second-degree tears may not need stitches if the wound is not heavily bleeding and the tear has not changed the natural structure of the vagina. If a tear does not need stitches, a doctor may repair the area with a skin adhesive instead.
Third- and fourth-degree tears require more extensive repairs. A doctor will administer a regional or general anesthetic and will perform the repair in an operating theater rather than the delivery room.
After repairing the internal and external anal sphincter, the doctor can stitch up the rest of the tear. Rarely, a person may need a second procedure to complete the repair.
A person may feel pain or soreness for 4–6 weeks after any vaginal tearing. A person may also be able to feel their stitches for up to 3 months, particularly if the stitches are around the anal area. The stitches will dissolve or fall out over time.
Several complications are associated with vaginal tears.
The
Aside from bleeding, a person with a vaginal tear resulting from childbirth may experience:
- delayed bonding with the baby
- infection
- pain and difficulty having a bowel movement
- stinging and pain during urination
- reopening of the wound
More long-term complications may include:
- painful intercourse
- bowel incontinence
- urinary incontinence
- vaginal or anal fistulas
Below are some strategies for preventing infection and minimizing the discomfort of vaginal tearing after childbirth:
- Keeping the area clean: Washing the vagina, anus, and perineum daily with water helps speed up recovery and prevent infection. Avoid using any products on the area and change sanitary pads regularly.
- Taking pain relief medication: Over-the-counter options such as ibuprofen (Motrin, Advil) and acetaminophen (Tylenol) can help.
- Taking antibiotics: A doctor may prescribe these to prevent bacterial infections.
- Staying hydrated and having a balanced diet: This can help prevent constipation, which could be painful for someone with anal stitches. A person can also use laxatives.
- Using water while urinating: Keeping a pitcher or bowl by the toilet and pouring water on the genitals while urinating may help relieve a stinging sensation.
If a person notices an increase in pain, a smell coming from the area, or any bleeding from the tear, they should speak with a doctor. These may be signs of infection.
Experiencing complications during childbirth can also cause emotional distress. Some people with vaginal tears may feel embarrassed by the symptoms of the tearing.
People who have had vaginal tears may also be at risk of developing post traumatic stress disorder.
A person should speak with a healthcare professional if they have been emotionally affected by a vaginal tear. A mental health professional may be able to provide additional support.
Experts have yet to agree on the best way to prevent vaginal tearing, but there are some techniques that a person can discuss with their doctor to minimize the risk during childbirth.
A doctor may suggest massaging the area between the vagina and the anus to reduce the risk of a tear. Perineal massage may work by:
- relaxing the muscles in the area
- increasing blood flow
- stretching the vaginal tissue
Some
However,
Other techniques that may prevent or minimize vaginal tearing include:
- lying on one side during childbirth and delaying pushing
- applying a warm compress during the second stage of labor
Most vaginal tears heal with no long-term complications. First-degree tears may heal on their own without needing stitches.
Vaginal tears should heal within 4–6 weeks. However, complications from tearing, such as incontinence or pain during intercourse, can last longer.
A person should not hesitate to speak with a doctor if they are concerned about any complications that may happen during or after childbirth.
Vaginal tears often result from childbirth. There are four degrees of tears, based on the amount and type of tissue affected.
A doctor can repair first- and second-degree tears in the delivery room after the birth. Third- and fourth-degree tears are more severe and may require more extensive surgery under general anesthesia.
A person can take some steps to minimize the risk of tearing during childbirth, such as having a perineal massage, using a warm compress, and lying on one side during the delivery.