The prospect of experiencing perineal (vaginal) tears during childbirth unnerves most pregnant women. In the same way men cringe and even ache “down there” when they hear that their friend took a hit to the groin, women experience an almost physical response to the thought of a tear in their delicate area.
Let’s take a closer look at what perineal tears involve so that you know what to expect should it happen to you.
What exactly is a vaginal tear?
“Simply put, vaginal tears are trauma to the vagina and vulva that occurs during childbirth,” says Dr Tania Victor, an obstetrician-gynaecologist at Blaauwberg Netcare Hospital in Cape Town. These tears are also referred to as perineal tears as they often extend into the perineum (the area between the vagina and the rectum).
Dr Victor explains that there are three different levels or grades of tearing:
1: Laceration of skin and superficial tissues without muscle damage.
2: Lacerations involving the skin, perineal body and muscles.
3: Lacerations involving the skin, perineal body and muscles and the anal sphincter, with or without laceration of the anal/rectal mucosa.
The good news about perineal tears
Fortunately, most tearing is superficial, that is, grade one. “In my experience, about 18 percent of first-time moms develop second-degree tears and only about two percent develop third-degree tears,” says Dr Victor.
Moreover, tearing is far less likely to occur when giving birth the second time round as the perineal tissue is much more flexible by then.
Preventative measures you can take
There are no surefire ways to prevent perineal tears – “The doctor must just try and support the perineum during delivery as much as possible,” advises Dr Victor.
She recommends doing Kegel exercises (exercises that strengthen your pelvic floor) beforehand to help strengthen the area and using EPI-NO, a balloon-like product that helps dilate the vaginal muscles (safe for use from 37 weeks pregnant).
“The treatment depends on the grade of the tear,” explains Dr Victor. “Most grade 1 tears don’t need suturing. Grade 2 and 3 tears are sutured in theatre.” Healing takes about 14 days, depending on the severity of the tear, and salt-water baths are recommended to keep the sutures clean.
With deep tears, discomfort in the area may persist for several weeks after the wound has healed and sex may be painful for a few months thereafter. Be sure to discuss ongoing symptoms with your gynaecologist.
An episiotomy: To cut, or not to cut?
An episiotomy – a surgical incision in the area to widen the vaginal opening – used to be common practice during delivery, however doctors have since found that natural tears heal better and episiotomies are therefore only used when absolutely necessary.
IMAGE CREDIT: 123rf.com