I’m sure you’ve heard stories about tearing when pushing during birth. Are you clenching your bottom together just thinking about it? Yeah, I’m not surprised. This is one of those possibilities in childbirth that everyone wants to avoid!
Let’s combat fear with facts.
The part of the body we are talking about is the perineum. This is the skin at the southern-most part of the vagina, facing the rectum. Its ability to stretch accommodates your baby descending and crowning.
Not all women tear in birth (YAY!) The truth is that while more than half of all vaginal births do result in some degree of tearing, most tears are minor enough that they heal within 7 to 10 days. The most common type of tear is a first degree tear which is usually repaired with just one or two stitches, and sometimes no stitches are needed at all.
Within a few minutes of birth, the doctor or midwife will check these tissues and repair any tears. Different types of tears will need different approaches for healing and soothing. The advice from your medical team could include OTC pain meds, using ice packs, witch hazel, epsom salts baths, or exposing the wound to air for better healing. The most severe injuries (3rd and 4th degree tears) occur in less than 2% of births, and when this occurs greater attention may be needed for complete healing.
Related to vaginal tearing is a procedure called an episiotomy. This is a small snip in the perineum to allow a little more space for the baby to descend. There was a time when episiotomies were routine, but that day has largely passed. The American Congress of Obstetricians and Gynecologists no longer recommends episiotomies as a routine procedure, but it is good for you to know that instances can occur in birth when episiotomies can be a very useful tool in urgent situations.
Women are voicing to their care providers that they want their vaginas to remain as intact is possible. Now in East Texas hospitals, episiotomies are performed at fewer than 10% of all births.
Many are worried: “If I tear, does it mean sex will always be painful?”
Look: if we’re completely honest, sex is different for most couples after birth! A little discomfort in the early weeks of intimacy is to be expected but women should not have lasting pain, and most women don’t. If you do have lasting pain that isn’t improving, a talk with your doctor is in order. A referral to a pelvic floor physical therapist will help you develop a plan and work towards full recovery of the vagina and restoration of healthy sexual function.
If preventing a tear or episiotomy is important to you, a conversation with your doctor or midwife will help your team develop a plan to reduce the risk of injury to you perineum in birth.
Let’s dispel the fear even further and prepare for great success! More tips for preventing tears including practicing pushing positions and techniques, as well as effectively communicating your needs with your care provider are included in our Childbirth Education Class and our doulas are invaluable resources for this as you prepare for birth, too. Drop us a line!