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Will I Tear in Labor?

By Sharon Scott, RN, MSN

Will I Tear in Labor?

As baby makes her grand entrance, her head puts tremendous pressure on the tissues and muscles between your vagina and anus, or what’s known as the perineum.

Tears are common in childbirth, especially in first-time moms, and experts will sometimes make a cut, called an episiotomy, to help prevent greater tearing. These cuts or tears can damage your body’s local nerves and blood vessels, causing you to need stitches to close or surgery to repair the wound, and post-recovery complications including painful intercourse or stool incontinence.

With a cut or tear, healing can take from weeks to months, depending on your situation. In either case, your provider will describe the needed repair, which is done to control bleeding, prevent infection and aid healing.

During healing, keep the area clean by rinsing with warm water after going to the toilet; wipe from front to back, and as advised, use pelvic floor muscle exercises to strengthen the area during recovery.

Recover Well

How you may tearAffected areaPromote healing
1st DegreeAffects tissues around the vagina only.Will heal within a few weeks. You may feel burning or stinging while urinating; ease with warm water or warm-water-soaked tea bags.
2nd DegreeAffects vaginal tissue and muscles between your vagina and anus; you’ll likely receive stitches.Use pain relievers and stool softeners; chilled witch hazel pads, and flush with warm water while going to the toilet; sit on a pillow-padded ring to ease pressure. Should heal within a few weeks.
3rd DegreeAffects same tissues and muscles plus muscles around anus; may need surgical repair.You may experience stool incontinence and painful intercourse; use all of the above comfort measures; can take months to heal.
4th DegreeAffects all above tissues plus the rectal tissue; these are the most severe; you may need to be referred to a specialist for surgical repair.You may experience stool incontinence and painful intercourse; use all of the above comfort measures. Can also take months to heal.

Am I At Risk for Tearing?

You may risk a cut or tear with any of the following:

  • You’re birthing a baby 8½ pounds or more.
  • Baby’s head is emerging face up.
  • It’s your first labor and birth.
  • You had tearing or an episiotomy with a previous birth.
  • Forceps are used to assist birth.

Sharon Scott, RN, MSN, is an expert advisor to Healthy Mom&Baby and Health4Mom.org.

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