OMG will my vagina ever be the same again? Childbirth – we don’t want it to hurt, we don’t want to tear. A tear in the perineum is a tear in the space between the vagina and anus.
There are different types of perineal tears:
1st degree tear – superficial, skin and mucosa only. It’s okay. May or may not need a few stitches
2nd degree tear – involves muscle of the perineum. It’s okay. A few stitches is needed to aid with healing
3rd degree tear – a deep tear, a bit nasty, involves the anal sphincter – the muscle responsible for controlling bowel motions.
4th degree tear – very nasty, where the wall between the anus and the vagina is broken.
Sadly, odds are stacked against vaginal-birth women for an intact perineum. According to the NSW Mothers and Babies Report 2015:
13% of birthing women had an intact perineum
53% had a 1st or 2nd degree tear
5% had a 3rd degree tear
0.32% had a 4th degree tear
29% had an episiotomy
In all my experience as a midwife, I have to say that the vagina heals very quickly. It’s a moist warm environment in which wounds heal quickly in. You need ice to the area for 24 hours. The stitches are dissolvable – they might feel a bit itchy around 3 weeks post birth but that’s just the healing process. Most women are back to having sex 6 – 8 weeks post birth – bit of lube helps. Your partner should not notice any difference. If sex does feel different it’s because your pelvic floor muscles are all stretched. Squeeze and lift – pelvic floor exercises, they’ll help big time.
Preventing a tear. Well there has been some research to show that perineal massage works. This is where 2 thumbs, yours or your partners, massage the lower part of the vagina in a U shape for a few minutes. You will need some good quality oil. This can be started at about 34 weeks pregnant and done about 2-3 times a week. It hurts a bit, can feel like it’s burning a bit – not unlike the burn you’ll feel giving birth. Knowing what it feels like will give you better control during pushing.
Research also shows that a warm towel on your perineum at pushing can also reduce your chance of a tear. It may not be offered to you, so ask or put it on your birth plan. It keeps the perineum relaxed. Less opportunity for a tear.
You can uncross your legs now – a tear is not the end of the world for most women. Your vagina will heal and will be a second thought to that beautiful baby of yours.