Vaginal tears in childbirth

Vaginal area 

Vaginal area

Vaginal tears during childbirth are relatively common. Most vaginal tears involve only the skin around the vagina. These first-degree tears heal within a few weeks. Some vaginal tears are more extensive and may take longer to heal.

First-degree vaginal tear 

First-degree vaginal tear

First-degree vaginal tears are the least severe, involving only the skin around the vaginal opening. Although you may experience some mild burning or stinging with urination, first-degrees tears aren’t usually painful. First-degree tears typically require no medical treatment and heal within a few weeks. To ease any discomfort during urination, pour warm water over your vulva as you’re passing urine.

Second-degree vaginal tear 

Second-degree vaginal tear

Second-degree vaginal tears involve vaginal tissue (vaginal mucosa) and the perineal muscles ? the muscles between the vagina and anus that help support the uterus, bladder and rectum. Second-degree tears often require stitches but usually heal within a few weeks.

To ease discomfort while you’re recovering:

  • Sit on a hard surface or padded ring.
  • Squat — rather than sit — on the toilet. Pour warm water over your vulva as you’re passing urine, and rinse yourself afterward. Press a clean pad firmly against the wound when you bear down for a bowel movement.
  • Cool the wound with an ice pack, or place a chilled witch hazel pad between a sanitary napkin and the wound.
  • Take pain relievers as needed.
Third-degree vaginal tear 

Third-degree vaginal tear

Third-degree vaginal tears involve the vaginal tissues, perineal muscles and the muscle that surrounds the anus (anal sphincter). These tears require surgical repair and usually heal within four to six weeks.

To ease discomfort while you’re recovering:

  • Sit on a hard surface or padded ring.
  • Squat — rather than sit — on the toilet. Pour warm water over your vulva as you’re passing urine, and rinse yourself afterward. Press a clean pad firmly against the wound when you bear down for a bowel movement.
  • Cool the wound with an ice pack, or place a chilled witch hazel pad between a sanitary napkin and the wound.
  • Take pain relievers as needed.
Fourth-degree vaginal tear 

Fourth-degree vaginal tear

Fourth-degree vaginal tears are the most severe. They involve the perineal muscles and anal sphincter as well as the tissue lining the rectum. Fourth-degree tears require surgical repair and usually heal within several months. However, complications — such as fecal incontinence and painful intercourse — are possible.

Your health care provider will evaluate your recovery at your postpartum checkup. If you experience complications from a severe vaginal tear, you may need to consult a colorectal surgeon or other specialist.