Vaginal Tears During Childbirth

July 3, 2019
Vaginal tears are common in childbirth and can be very painful. Discover more about vaginal tears and how to prevent them.

Vaginal tears are a complication that can have serious consequences.

However, even in the most difficult cases, with timely and effective care, these injuries can be healed and do not pose any serious complications.

Tears are more frequent in deliveries with forceps or when an episiotomy was performed.

Many medical professionals around the world are investigating the most effective way to reduce the incidence of labor tears. However, there are some preventive measures that can be taken to minimize the likelihood of tearing during childbirth.

What are Vaginal Tears?

newborn baby

Vaginal tears in childbirth are a rupture of the skin of the perineum, or the area between the vagina and the anus. This is a frequent occurrence during childbirth and affects a large number of women who have vaginal deliveries.

A vaginal tear is also known as a perineal tear. These tears happen when the baby passes through the birth canal. This causes tearing to some of the muscles located at the floor, or bottom, of the pelvic region.

These tears vary in severity. They can range from small cuts to deep lacerations. Generally speaking, they are caused by skin that has not been sufficiently prepared for childbirth and does not stretch properly during delivery.

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Why Do Vaginal Tears Occur during Childbirth?

Some conditions make women more prone to suffer tears during labor. For example, women having their first baby or women who have suffered from a third or fourth degree tear in a previous birth are more likely to suffer from tearing during labor. Some other conditions that may affect tearing include:

  • The baby is very big.
  • Having an induced labor, especially if forceps are used.
  • Having or previously having an episiotomy, or an incision that doctors make to expand the birth canal.
  • The baby is born facing upwards, sitting, or is born a breech baby.
  • The shoulders of the baby are poorly located in the pelvis of the mother.
  • Pushing began too early or is too hard.
  • When the distance between the vaginal orifice and anus is very small.

Degrees of Vaginal Tears in Childbirth

woman in labor to prevent vaginal tears

Tears are classified into four degrees depending on their severity. The four degrees are as follows:

  • First degree: these occur when the skin of the perineum suffers a small, superficial cut. In this case, the wound heals easily without any major consequences.
  • Second degree: the cut superficially affects a part of a muscle in the perineal region. Stitches are required.
  • Third degree: the tear affects the muscles of the perineum and cuts all the way to the anal sphincter.
  • Fourth degree: the cut affects the entire perineal area, the anal sphincter and the anus wall. Both this and the third degree tears have a difficult and painful recovery.

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How to Tearing During Childbirth

water-birth to prevent vaginal tears

The best way to prevent vaginal tears during labor is to take some preventive measures during the pregnancy. These preventative measures are also useful for avoiding an episiotomy during delivery. The primary prevention methods include the following:

  • Perineal massage: applying massages to the perineal area using oils that are suitable and healthy for that region. This helps give elasticity to the muscles and skin in that area.
  • Kegel exercises: this technique strengthens the vaginal muscles. It is recommended to do them every day starting during the fifth month of pregnancy.
  • Slowing down the baby’s passage through the birth canal. This helps the muscles to have time to prepare and reduces the force with which the baby exits.
  • The position of childbirth: there is evidence that some positions favor the perineum. Sitting, standing, or lying on your side are all examples. Also, water births have a lower rate of tears.
  • Warm compresses: they serve to give more elasticity to the muscles and help to alleviate pain during delivery.

The application of commercial oils by themselves and vaginal dilators that inflate like a balloon have no major effect on the elasticity of the vaginal muscles or the dilation of the vagina.

Are you pregnant? Are you worried about vaginal tears during labor? Follow the advice given above to decrease the possibility of tearing during childbirth. Of course, do not forget to discuss any doubts or concerns with your obstetrician.

  • Sánchez Casal, M. I. (2012). EPISIOTOMÍA VERSUS DESGARRO. Revisión de las evidencias científicas. Enfermería Docente.
  • Ferri Morales, A., & Amostegui azkúe, J. M. (2004). Prevención de la disfunción del suelo pélvico de origen obstétrico. Fisioterapia. https://doi.org/10.1016/S0211-5638(04)73110-7
  • Vardon, D., Reinbold, D., & Dreyfus, M. (2015). Episiotomía y desgarros obstétricos recientes. EMC – Cirugía General. https://doi.org/10.1016/S1634-7080(14)67435-8