A perineal tear refers to a tear that can occur in the area between your vagina and anus (known as the perineum) while you deliver your baby, or in the case of twins, babies. This most frequently occurs in mothers that are giving birth vaginally for the first time. In most cases, perineal tears are treated using stitches, which dissolve by themselves within a week or two.
There are varying degrees of perineal tears, including:
- First-degree, which are small and only skin deep. These will heal on their own.
- Second-degree, which are deeper and involved the perineal muscle. These will need to be stitched.
- Third-degree, which involve the muscle that controls the anus. These will also be treated with stitches.
- Fourth-degree, which involve the lining of the anus. Again, these will be treated with stitches.
What should you expect from a perineal tear?
You should expect to feel uncomfortable, and the tear may even be painful. The extent of pain and discomfort is dependent on the degree of how deep your tear is. It will be most painful right after you have given birth, but you will start to feel better as each day goes on. You should expect to feel pain during several activities including:
- Bowel movements. Your first bowel movement after giving birth, in particular, will be painful.
You may also experience certain complications that can follow a perineal tear. These include:
- Infection, which is often characterised by red swollen skin, pain, a distinct odor and pus or liquid from the cut.
- Scar tissue, which is often raised or itchy and develops on the location of the tear.
- Painful sex. For women that suffer from perineal tears, sex can be painful for a few months. However, this won’t last forever, and you will be able to have pleasurable sex again in a few months.
How long will it take to recover?
As each woman is different, the time it takes to recover from a perineal tear is largely dependent on the degree of the tear. Therefore, women that have deeper tears are more likely to take longer to recover. However, you should expect to be fully healed in 4-6 weeks, after which you will be able to fully enjoy your new babies. Additionally, there are things you can do to help yourself heal quicker!
How can I recover from a perineal tear?
There are several things you can do to help your body recover, including:
After you have given birth, it is important for your body to rest, regardless of whether or not you have a perineal tear. Therefore, try to rest as much as you can. Sleep when your babies sleep, as it can help you recover. It is important to figure out how much sleep you and your babies need, and stick to it.
2. Treat your pain
There are several ways you can treat your pain if need to be. This is especially important for women that suffer from severe perineal tears. Ways to treat your pain include:
Placing an ice pack wrapped in a towel or cloth on the area of the tear.
Have a warm bath, as that can help ease the pain.
Inflatable cushions can help make sitting more comfortable for you.
Try taking a painkiller. Talk to your doctor for which painkiller is appropriate for you if you are breastfeeding as some painkillers can pass to the baby through breastmilk.
If bowel movements are painful, you can try using laxatives or stool softeners. Use essential oils, as they are known to help improve pain and soreness.
3. Reconstructive surgery
You might find yourself feeling insecure about the appearance of your vagina, and mental health is as important as physical health. Think of it as a battle scar. However, if the appearance of your vagina starts to affect your confidence, then there are ways to remedy the situation. Treatments, such as vaginoplasty, can help restore your vagina to its original shape.
4. Watch your diet
While you can eat normally once you have given birth, you should try to watch your diet and avoid foods that make you constipated. You can try taking a fibre supplement every day. You should also try to drink plenty of fluids.
5. Be active, but don’t overdo it
There are certain activities you can do that can help you aid your healing process. These include:
- Take a walk each day. Start off slow and then build up to longer times or distances. Walking is known to help improve blood flow and helps constipation.
- Do pelvic floor or Kegel exercises. These are known to help improve blood circulation and reduce pressure on the cut. Pelvic floor exercises include squeezing the muscles of your vagina and anus.
- Don’t carry out vigorous activities, such as running, aerobic exercise or weightlifting. You should wait at least a few months or get the “go ahead” from your doctor before you do any intense activities.
- Try not to lift anything too heavy.
There are other things you should also consider when trying to heal from a perineal tear:
- If you have vaginal bleeding, do not use tampons and wear sanitary pads instead.
- Make sure to keep your perineum clean by pouring or spraying warm water on it after you use the toilet. It might also help if you use baby wipes to wipe up after yourself instead of toilet paper.
- Make sure to attend all of your follow-up appointments.
If you experience a perineal tear, don’t worry, you will heal from it. For most women, the tears are very minor and will heal quickly. It will all be worth it because at the end of it, you will have your beautiful babies. It is important to keep in mind that you should seek medical attention if your perineum becomes red, painful and swollen, as you may have developed an infection.
Dr. Ammar Mahmoud
Dr. Mahmoud is a board eligible gynecologist and highly trained cosmetic surgeon specializing in cosmetic and functional gynecological medicine.