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Everything you Need to Know about Perineal Tearing and What You can Do to Minimize Tearing!

What are the different stages of perineal tearing?

Giving birth is not a walk in the park. I know, I have been there, done that! So, to all the mothers in the world – a big round of applause to all of you. 

If you are one of those millions of women who gave birth, you already know how intense but beautiful a journey it can be! For those new mommas, this is not to scare you but to set your expectations right. 

Childbirth is a transformative event in every woman’s life. Being a mother presents different unique changes – physically, emotionally, and even psychologically. The postpartum phase can be even more challenging especially for mothers who experienced perineal trauma as a result of childbirth.

What are perineal tears?

Perineal tears or trauma is a common result of childbirth trauma due to spontaneous vaginal birth. Research shows that 85% of all women will experience some kind of tearing during childbirth. 

There are four basic categories of perineal tearing: 

First-degree perineal tear

These are the least severe, small tears that only affect the skin. The skin between the vaginal opening and the rectum and the tissue beneath the skin… You might experience a bit of discomfort or slight pain when urinating but this usually heals quickly and without treatment. 

Second-degree perineal tear

Second-degree tear affects the muscle of the perineum and the skin. These usually require stitches by using a local anesthetic once you’ve delivered your baby. These tears do not cause long-term problems but can make you feel sore after the operation.

Third-degree perineal tear

Third-degree perineal tear extends into the muscle that surrounds the anus. These tears sometimes require repair and might take longer to heal. Complications such as stool leakage and painful intercourse are possible. If these happen, be sure to consult your doctor or specialist.

Fourth-degree perineal tear

A fourth-degree perineal tear is the most severe among the tears. The tear extends through the anal sphincter and into the mucous membrane that lines the rectum. These tears usually require repair with anesthesia in an operating room. It requires a more specialized repair.

Healing might also take longer and infections may also happen and painful intercourse is also possible. Hence, if these complications occur, be sure to seek an evaluation by a pelvic floor physical therapist.

How to ease discomfort

Depending on how severe your vaginal tear is, your doctor or caregiver will evaluate your recovery when you get back for a postpartum check-up. Be sure to ask your OBGYN or Midwife for a pelvic floor physical therapy referral at your 6-week check up. If you have gone past the 6-week check up, it is not too late to seek pelvic floor PT!

Here are some ways you can do while recovering:

  • Use an ice pack regularly to cool the area for 2-3 days after giving birth to reduce the swelling
  • Rinse the vagina using warm water during and after urinating to reduce the stinging 
  • Take pain-relief medicines as advised by your doctor or healthcare provider
  • Drink a lot of water and eat healthily to avoid constipation
  • Take extra care with your hygiene to help prevent the occurrence of infection. Epsom Salt Sitz Baths are an excellent choice to clean the area.
  • Avoid strenuous movements the first month postpartum.
  • Avoid having sexual intercourse until your doctor or healthcare provider advises that it is already safe to do so
  • Ensure that you attend your scheduled follow-up appointments with your doctor or healthcare provider

If you are interested in joining a birth class that helps prevent perineal tearing, click here to learn more about my virtual birth class, the Push Lab!

From your girl on the internet that cares about your motherhood journey

Xo, Dr. Betsey

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