Perineal Tearing During Birth Explained
Not everything about giving birth is positive. In fact, delivery itself can be very traumatic to the body. The process also comes with terrifying consequences that can affect your body and mind later on in life. In addition to pain, a lot of women fear vaginal tears.
What Does Vaginal Tearing Means?
Vaginal tearing refers to the spontaneous laceration of the perineum or the area just between the rectum and the vagina. It happens as the baby is being pushed out.
Normally, the vagina stretches to allow a baby to pass. However, in some cases, it fails to stretch enough and that’s when tearing happens.
First-time moms have a higher chance of experiencing it as their tissues in the area are less flexible. Apart from that, women who are overweight and those having forceps- or vacuum-assisted delivery are also at a higher risk.
Having a big baby is a factor, too.
The good news is that after the first vaginal birth, the perineal tissues become more flexible, minimizing the risk of tearing.
4 Types of Perineal Tears
In general, there are four types of lacerations or tears.
1. First degree lacerations happen when the skin is torn but don’t require any or minimal stitches.
2. Second-degree lacerations, on the other hand, involves both the skin and muscles underneath, requiring a few stitches.
3. Third-degree lacerations involve the vaginal skin, perineal skin as well as the muscles around the anus.
4. The most severe type, fourth-degree tears are similar to third-degree lacerations but extends deeper into the anal sphincter and the surrounding tissues.
How to Minimize Tearing During Child Birth
While there’s no guarantee that you’ll be able to completely prevent vaginal tearing, there are steps you can take to minimize your risk of experiencing severe tears. However, since your doctor is responsible for the safety of your baby and you he/she will guide on what is best.
Start by preparing your body
Going through labor is no joke. Your body will experience things it has never experienced before. With that, you have to make sure that your body is in good shape once you’re due to give birth.
Exercise can help improve your circulation. And when there’s good circulation, you’ll have better skin elasticity.
Pregnant women are told to do pelvic floor exercises or Kegels to boost the strength of the pelvic floor. Doing these exercises and being consistent in performing them can help your pelvic floor muscles snap back into shape after birth. They can help minimize your risk of experiencing incontinence, too.
Apart from exercise, you also may want to consider checking your diet. Make sure to eat foods that support your muscle and skin health. Add more good fats into your diet and eat more vegetables with vitamins C and E and zinc.
Choose the right birthing position
Believe it or not, the position you’re in during delivery can influence your risk of perineal tearing. For example, lying down or being in a semi-reclining position increases your risk of experiencing a tear in your perineum.
The best position for giving birth is the one you feel most comfortable in. However, the least stressful positions for your perineum include lying on your side, leaning forward in a sitting, standing or kneeling position, and being on all fours.
Get a warm compress
A warm compress can increase the blood flow to your perineal area. It can reduce severe tearing and provide comfort.
Epidurals are great for pain. However, since you won’t feel anything with them, you may not realize the urge to push. And without the urge to push, you may simply rely on your healthcare provider coaching you to bear down. This increases the risk of vaginal tearing.
To lessen that possibility, you may want to consider getting a lighter dose. Additionally, you may also want to discuss with your provider the best positions you can assume once the epidural is given.
Push only when there is the urge to do so
Most women think that being fully dilated means that they should start pushing. If there’s really no emergency, don’t rush the process and wait for the urge to push the baby out.
Do a perineal massage
Perineal massage involves manually stretching the perineal area to prepare it for childbirth. Doing it daily should help the skin to start becoming looser. You can use oil or any water-based lubricant for it.
Now, before you actually start doing the massage, it’s best to talk with your doctor first, particularly if you have active herpes. It will increase the risk of spreading the infection throughout the genital tract.
Episiotomies are surgical cuts made to the perineal area in an attempt to enlarge the vaginal opening. First used at the same time forceps were utilized in childbirth, the cuts are believed to minimize the damage to both mother and child.
Unfortunately, episiotomies can’t protect the perineum. In fact, it’s the other way around.
An episiotomy can increase a woman’s risk for third and fourth-degree lacerations. Once the perineal skin and muscles are cut, the baby’s head can cause the cut to tear deeper.
In addition to that, episiotomies can also cause incontinence, trauma, and infections.
Recovering from Perineal Tearing
Your recovery will depend on the type of laceration you experienced.
A first- or second-degree laceration can cause some discomfort. You may not be able to sit straight for about a week or so. You may also find sneezing, coughing, and having a bowel movement quite painful, too.
Sex will continue to be uncomfortable up to the 6th week. This, however, will depend on where the tear is and the quality of stitches.
For third- and fourth-degree lacerations, healing can take a longer time. The discomfort can last for several months. To help with the pain, you’ll be given stool softeners and asked to eat more fiber-rich foods.
These types of lacerations can increase your risk of urinary and bowel problems, prolapse, and pain during sexual intercourse. Be sure to talk to your doctor about every symptom you experience- no matter how embarrassing and uncomfortable they are. The earlier you get checked for such complications, the earlier treatment can get started. It’s one way to minimize more serious complications.