Many women experience some kind of tear, either naturally or via an episiotomy, during childbirth as the baby stretches the perineum, the area between the vaginal opening and the anus.
After your baby is born, your healthcare provider will examine your vagina, perineum, and rectum to see if you have a tear. Some women feel the tearing, but others, especially those who have had an epidural, do not know it is happening. For most women, vaginal tearing is minor and heals quickly on its own. This is called a first-degree tear. A second-degree tear requires stitches. A third- or fourth-degree tear is infrequent and requires a surgical procedure to repair the injury.
Preventive Measures against Tearing
There are a few things that you can do to try to prevent or minimize tearing, including keep your perineum warm during labor using a warm cloth, and, rather than lying flat on your back during delivery, sit up or lie on your side.
How To Care for a Vaginal Tear
Once you are home, here are some things you can do for any degree tear you experience:
Apply an ice pack.
Take a sitz bath.
Use a donut pillow to take pressure off your perineum area.
Use a squirt bottle (peri-bottle) with lukewarm water to clean yourself.
Rather than wiping, pat yourself dry with toilet paper.
Take an over-the-counter pain medication.
Avoid exercise, movement, or heavy lifting that would prolong the healing process.
When to Call your Provider
With a tear, stitches or a more serious repair procedure, you may experience bleeding, soreness, incontinence, and painful intercourse (once your medical provider says this is okay). Call your doctor, midwife, or nurse if you see any signs of infection: excessive pain, a fever, or bad-smelling discharge
A Few Final Notes
If you have had tearing with a past delivery, you may wonder if you can attempt a vaginal delivery the next time and if you will tear again.
In most cases, you can have a vaginal delivery even if you had tearing during a previous delivery. And, most women tear less with subsequent deliveries
It is helpful to know what to expect throughout the first weeks and months at home with your new baby. Tennessee Family Doulas are ready to answer your questions (especially, “Is this normal?”) and even provide in-home and overnight care. We would love to hear from you and walk with you on this journey!
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