Mayo Clinic Health Library

Slide show: Vaginal tears in childbirth

Updated: 10-08-2018

Vaginal area

Illustration of a vagina and anus

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.

1st-degree vaginal tear

Illustration of a first-degree vaginal tear

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.

2nd-degree vaginal tear

Illustration of a second-degree vaginal tear

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.

3rd-degree vaginal tear

Illustration of a third-degree vaginal tear

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.

4th-degree vaginal tear

Illustration of a fourth-degree vaginal tear

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.

Easing discomfort

Photo of a woman talking to her doctor

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:

  • Sit on a pillow or padded ring.
  • Cool the wound with an ice pack, or place a chilled witch hazel pad between a sanitary napkin and the wound.
  • Use a squeeze bottle to pour warm water on your perineum as you're passing urine.
  • Sit in a warm bath just deep enough to cover your buttocks and hips (sitz bath) for five minutes. Use cold water if you find it more soothing.
  • Take an over-the-counter pain reliever. Ask your health care provider about a numbing spray or cream, if needed.
  • Talk to your health care provider about using a stool softener or laxative to prevent constipation.
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