Vaginal tears are rips in the skin and muscle above or near the vaginal opening. Tears most commonly occur in the perineum. The perineum is the region between the anus and the opening of the vagina. There are four degrees of vaginal tears:
This serious condition is not common. When it occurs, it is usually during vaginal birth .
Vaginal tears may be caused by any of the following:
If you are a very small woman carrying a very large baby, your doctor will be aware of this risk before you deliver your baby. She will be able to help you.
Tell your doctor if you have any of these risk factors:
There are usually no symptoms of vaginal tears. A sign might be may be increased bleeding from the vagina.
Your doctor will be with you during labor and will see any tearing if it happens. The seriousness will be based on the size of the tears and what muscles are affected. If the doctor thinks you may tear, she may recommend an episiotomy . This is a surgical incision of the perineum. An episiotomy will make the vaginal opening temporarily larger so that the baby does not tear the vagina or its surrounding muscles.
Talk with your doctor about the best treatment plan for you. Treatment options:
First degree tears are superficial. They often do not require stitches and will heal naturally. Second degree tears are deeper into the tissues, require a few stitches, and then heal well afterward. Third degree tears involve the rectal muscles, and fourth degree tears enter into the rectum. These tears require more time and stitches to repair. In rare cases of abnormal healing, additional surgery is sometimes needed to repair significant tears.
Other treatments that can be used at home to lessen the pain of the stitches include :
If you are diagnosed with vaginal tears, follow your doctor's instructions .
To help reduce your chance of getting vaginal tears, take the following steps:
The American College of Obstetricians and Gynecologists
Women's Health Matters
Benefits and risks of episiotomy: a review of the English–language literature since 1980. Gentlebirth.org website. Available at: http://www.gentlebirth.org/format/woolley.html . Accessed August 9, 2005.
Episiotomy: a cut you may not need. Mayo Clinic website. Available at: http://www.mayoclinic.com/invoke.cfm?id=HO00064 . Accessed August 9, 2005.
Managing complications in pregnancy and childbirth: repair of vaginal and perineal tears. World Health Organization website. Available at: http://www.who.int/reproductive-health/impac/Procedures/Repair_vaginal_P83_P90.html . Published 2003. Accessed July 11, 2008.
Repair of obstetric perineal lacerations. American Academy of Family Physicians website. Available at: http://www.aafp.org/afp/20031015/1585.html . Accessed August 9, 2005.
Last reviewed February 2009 by Ganson Purcell Jr., MD, FACOG, FACPE
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.