Vaginal tears during childbirth, also called perineal lacerations or tears, occur when the baby's head is coming through the vaginal opening and is either too large for the vagina to stretch around or the head is a normal size but the vagina doesn't stretch easily. These kinds of tears are relatively common.
Tears that involve only the skin around the vagina typically heal on their own within a few weeks. Some tears are more extensive and require treatment. Your health care provider will carefully examine you after delivery to identify and repair any injuries.
First-degree tears are the least severe, involving only the perineal skin — the skin between the vaginal opening and the rectum and the tissue directly beneath the skin. You might experience some mild pain or stinging during urination. These tears might or might not require stitches and typically heal within a few weeks.
Second-degree tears involve the skin and muscle of the perineum and might extend deep into the vagina. Second-degree tears typically require stitches and heal within a few weeks.
Third-degree tears extend into the muscle that surrounds the anus (anal sphincter). These tears sometimes require repair with anesthesia in an operating room — rather than the delivery room — and might take longer than a few weeks to heal.
Complications such as stool leakage (fecal incontinence) and painful intercourse are possible. If these problems occur, talk to your health care provider.
Fourth-degree vaginal tears are the most severe. They extend through the anal sphincter and into the mucous membrane that lines the rectum (rectal mucosa). Fourth-degree tears usually require repair with anesthesia in an operating room — rather than the delivery room — and sometimes require more specialized repair. Healing also might take longer than a few weeks.
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, typically six weeks after delivery. If you've had a third-degree or fourth-degree vaginal tear, you might need to see your doctor more often to ensure early detection of any problems. Tell your health care provider if you're experiencing severe, persistent or increasing pain, which could be a sign of infection. If you experience complications from a vaginal tear, you might be referred to a urogynecologist, colorectal surgeon or other specialist.
To ease discomfort while you're recovering: