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The Truth About Tearing

by | Aug 8, 2016 | Labor & Birth, Sex

You’ve heard the horror stories. You’ve googled the cringe-worthy photos of 4th degree tears. You’re scared of tearing while pushing during birth and even with a little vaginal tear, you’re wondering

“Will my vagina ever be the same again after birth?”
But let’s be honest, your biggest fear of all is tearing from hole to hole. Ouch!

It’s even got you thinking maybe you would be better off going straight for the cesarean birth in order to keep your vagina intact and back to business ASAP after birth.

Your fears are totally normal. Tearing can be totally normal. NOT those 4th degree tears you’ve been googling but minor tears occur in about 90% of vaginal births.

Not all vaginal tears are created equal. There are different types of tears with different recoveries. So let’s break it down:

1st and 2nd degree tears are the most minor of all tears. It involves only the skin around the vagina or perineal skin and sometimes the muscle between the vagina and anus. It may require a little bit of suturing.

3rd and 4th degree tears involve more of the muscle of the vagina and anus and can even extend to the tissue around the anus. It requires careful suturing and follow up with your provider.

Recovery is going to vary depending on the type of tear.

With first and second degree tears, recovery may be a bit uncomfortable, that peri bottle the hospital provides will become your best friend.  You may have increased pain when sitting straight, having a bowel movement, sneezing, or coughing. By two weeks, your discomfort has diminished for the most part. The first time you have sex after birth can be a bit uncomfortable but you will be back to your old habits and look in no time.

For third and fourth degree tears, recovery can be a bit more involved and need additional treatment from your provider to heal properly. This is why it is important to discuss all you’re feeling with your provider, no matter how embarrassing. They’ve already heard and seen it all. Remember, these types of tears are not common.

By this time, I’m sure you’re ready to ask your OB or midwife

“What can I do to prevent tearing during pushing?”

While tearing is not always preventable, you can discuss with your provider about your position options during pushing to a position that puts less pressure on the perineum and pushing in the moments you feel the urge, which can even be possible with an epidural. During the pushing phase, your provider can also support our perineum by putting pressure with a warm cloth or lightly stretching your perineum with their finger as your baby is beginning to crown. Most importantly, the first step to easing your fears and preventing vaginal tears is to discuss your concerns with your provider and come up with a plan together.

But what about episiotomies?

 Is it better to tear or have an episiotomy?

An episiotomy is an incision your provider makes to your perineum. While it can be necessary and life saving, most OBs do not do them routinely anymore as the American College of Obstetrics and Gynecology recognizes episiotomies can sometimes be more harmful than helpful with greater recovery time.

Hiring a birth doula doesn’t prevent tearing but can get you comfortable, help you voice your concerns about tearing during pregnancy and even during pushing, but most importantly, they can ease your fears about the entire process. Mainstay Doulas & Co. offers the best birth doulas, virtual or local in Miami and Milwaukee, and are ready to listen to your fears of the smallest tears to a fourth degree tear and help you figure out the best options for you.



We are doulas living in Miami with a love for cafecito, pregnancy and newborns. We are the experts and the moms who have been there sharing our best tips and tricks with a side of inspiration. Our goal? Help you kick ass at this parenting gig.

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