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Slide show: Vaginal tears in childbirth

Slide show: Vaginal tears in childbirth

Vaginal tears during childbirth are common. See illustrations of various degrees of vaginal tears and treatment tips.

Vaginal tears during childbirth, also called perineal lacerations or tears, occur when the baby''s head is coming through the vaginal opening and is too large for the vagina to stretch around. These kinds of tears are relatively common.

Tears that involve only the skin around the vagina typically heal within a few weeks. Some tears are more extensive and take longer to heal. If the pain seems excessive or gets worse, contact your health care provider. Excessive pain could be a sign of infection.


First-degree tears are the least severe, involving only the skin around the vaginal opening or perineal skin. Although you might experience some mild burning or stinging with urination, first-degrees tears aren''t severely painful and heal within a few weeks. They may or may not require stitches.

To ease any discomfort during urination, use a squeeze bottle to pour warm water over your vulva as you''re passing urine.


Second-degree tears involve the perineal muscles — the muscles between the vagina and anus that help support the uterus, bladder and rectum. Second-degree tears typically require stitches and begin to heal within a few weeks.

To ease discomfort while you''re recovering:

  • Sit on a pillow or padded ring.
  • Pour warm water over your vulva as you''re passing urine, and rinse yourself with a squeeze bottle afterward. Press a clean pad firmly against the wound when you bear down for a bowel movement.
  • Cool the wound with an ice pack, or place a chilled witch hazel pad between a sanitary napkin and the wound.
  • Take pain relievers or stool softeners as recommended by your health care provider.

Third-degree tears involve the perineal muscles and the muscle that surrounds the anus (anal sphincter). These tears sometimes require repair in an operating room — rather than the delivery room — and might take months to heal.

Complications such as fecal incontinence and painful intercourse are possible. If these problems occur, talk to your health care provider.

To ease discomfort:

  • Sit on a pillow or padded ring.
  • Pour warm water over your vulva during urination, and rinse yourself with a squeeze bottle afterward. Press a clean pad against the wound when passing a bowel movement.
  • Cool the wound with an ice pack, or place a chilled witch hazel pad between a sanitary napkin and the wound.
  • Take pain relievers or stool softeners as recommended.

Fourth-degree vaginal tears are the most severe. They involve the perineal muscles and anal sphincter as well as the tissue lining the rectum. Fourth-degree tears usually require repair in an operating room — rather than the delivery room — and might take months to heal.

Complications such as fecal incontinence and painful intercourse are possible. If these problems occur, talk to your health care provider.

Your health care provider will evaluate your recovery at your postpartum checkup. If you experience complications from a vaginal tear, you might be referred to a urogynecologist, colorectal surgeon or other specialist.


2015-04-08

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