Childbirth seems to defy the laws of physics. When you think about your size now and then, picture an eight-pound baby making his way out of you, and it’s hard not to wince in pain. However, the female body is made for such a feat, so you simply have to trust that it will happen naturally. However, the body could be slightly overcome by the task, and perineal tears are not uncommon. Perineal tears are lacerations that occur on the skin between the vagina and anus during childbirth. These lacerations could range in severity from minor nicks to deep cuts affecting multiple layers of skin. These tears are more common if you receive an episiotomy, which is a surgical cut to the same area. The cut is supposed to make childbirth easier for women who are not dilating enough, but they do tend to pave the way for tears.

First-degree lacerations are the most minor, and they only involve the outer layer of the vagina. No muscles are torn, so stiches are rarely needed to repair them. If you have a first-degree laceration after childbirth, it will only take a few weeks to fully heal.

Second-degree lacerations are deeper. They can tear several layers of muscles, which will all need to be stitched individually. Although healing time will be uncomfortable, it will again only take a few weeks to heal.

Third and fourth-degree lacerations are much more serious. They can cause pain for several months and can also cause anal incontinence. These severe tears affect muscle and tissue all the way back to the sphincter.

Obviously, this added pain during your birth is not something you’ll want to deal with, so it’s important to know the risk factors for a perineal tear. If this is your first vaginal birth, you are more at risk for a tear because the muscles have never been stretched before. You should also avoid getting an episiotomy, as they put you more at risk and they have very few benefits. If your baby is larger than average or born in the face-up position, you’ll be more at risk for a tear.

Unless you opt for a cesarean section, there is really no way to fully guarantee you won’t suffer a perineal tear. While the healing period is painful, there are no serious complications associated with them, and they’ll heal fully with proper stitching and medical care.

Source: O. Eskander et al: Risk Factors For 3rd And 4th Degree Perineal Tear. Journal of Obstetrics and Gynecology Volume 29 Issue 2 pp. 119-122 2009

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