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Vaginal Tearing and Child Birth

There are uncomfortable childbirth experiences we would rather forget. The tearing of vagina during childbirth is one of them, which is a very common experience  for first-time moms.

Facts on vaginal tear

Also known as perineal lacerations, this is a cut or an abrasion which occurs in the area between your rectum and the vaginal during when the babies head pushes through the vaginal opening. Ordinarily, the vagina is supposed to stretch to allow head to pass. Often a tear occurs when the stretching is not enough.

Tearing risks

For first time mothers, the risk is high, as high as 95%.The other factors are:

  • Overweight
  • Fast birth
  • Baby’s position
  • Vacuum/forceps assisted delivery
  • Prolonged labour

However, the risk decreases after first birth due to flexibility of the tissue.

Types of vaginal tears

There are 4 types as discussed below:

First-degree tear

Occurs on vaginal lining and may require a bit of suturing. No muscles are involved.

Second-degree tear

This is the commonest, affecting the lining and deeper vaginal tissue. This, too, requires stitching.

Third-degree tear

Affect layers, muscles and sphincter. The layers have to be stitched separately with focus on sphincter-supporting muscle layer.

 Fourth-degree tear

Combines all tears and requires stitching several layers. Usually experienced due to use of forceps, vacuum or baby’s shoulder getting stuck. It’s usually least common, though.

 Recovery

As you recover from first and second degree tears, you will experience:

  1. Discomfort due to sitting straight up for 7 days or more
  2. during bowel movements
  3. Coughing, sneezing
  4. Painful sex in the first 6 weeks

During week 2, healing will have taken place and stitches dissolved. Nerves and muscles take longer to heal

For the third and fourth degree tears:

  1. Pain lasts 2-3 weeks

2discomfort during sex

  1. Painful bowel movement

Effects of severe tearing

These include:

  • Urinary problems
  • Prolapsed or dysfunctional pelvic floor
  • Uncomfortable sex
  • Bowel movement difficulty

What to do

Do the following:

  1. Take fiber-rich foods
  2. Use stool softeners
  3. Use sitz baths and cold compresses
  4. Share embarrassing symptoms with doctor

 

Preventing severe vaginal tearing

Position matters a lot, hence are in a position of least pressure on the perineum. Examples include:

-squatting in an upright position

-lying on the side

-forward leaning

-leading in the push during labour phase

-applying warm compress to perineum

-perineal massage for up to 15 minutes before birth date. This is done 4-6 weeks before childbirth

NB: consult your doctor before perineal massage and especially if you have a history of herpes to prevent virus infection in the genital tract.

What is perineal massage?

It involves massaging the vaginal base with lubricants to soften the surrounding tissue and increasing flexibility.

 

 

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Australia Plastic Surgery Sydney

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