As you are pushing and your baby is just about to be born, a lot of pressure is applied to your perineum, the tissue between your vagina and rectum. Sometimes, this results in “tearing.”
Can we agree that the word 🚨tearing 🚨is kind of awful when we’re talking about birth? Honestly so much of the language surrounding birth is violent and scary. But this one specifically makes moms-to-be nervous (and I totally get it).
Let’s spend a minute chatting about it.
For starters, instead of tearing, try to think about the word “release.” It does not tear like a piece of paper. The tissue releases as pressure is applied from your baby’s head.
Your (very smart) perineum knows exactly if, where, and when to release. Emphasis on the word “if” because it doesn’t always happen.
I also want you to know that in my experience, it is rare for a woman to FEEL that tissue release. There is so much going on in those moments (emotions, sensations, and more) that so often women do not realize it’s happened until after the fact, when their provider takes a look and tells them.
Here are a few other things I want to share about t-e-a-r-i-n-g: Tearing is classified into degrees of severity, 1st degree being relatively minor all the way to 4th degree, which is serious. The good news is that the vast majority of tearing is 1st and 2nd degree.
- If you tear, your provider will likely stitch the area to promote healing. If you have an epidural, you probably won’t feel the stitching too much. If you do feel it, or if you don’t have an epidural, you can receive an injection of local pain medication, just like when you go to the dentist. Good news: The stitches dissolve on their own, no need to have them removed. 🙌
- Vaginas are excellent at healing themselves. While those first days after giving birth can be uncomfortable, take heart in knowing that most tears heal within a few weeks. Use sitz baths (this is a great sitz bath, and then here is a wonderful solution to add to it), take ibuprofen if you’re able, and sit with your legs together to help promote faster healing.
- If you find that you are still having a lot of pain, or any other concerns, a few weeks out, do not hesitate to reach out to your provider. Complications are rare but they happen, and early diagnoses is key. This goes for longterm concerns as well. That you’ve given birth does NOT mean that sex should be uncomfortable or that you should always pee a little when you cough. “That’s how it is not” is unacceptable. Reach out to a pelvic floor physical therapist to help you address any of these problems.
There are ways to minimize or prevent tearing:
- Ask your provider to teach how you to do perineal massage (or check out these tips here).
- As you are crowning, change your big mighty pushes into short and gentle “push-ettes,” to ease your baby out more gently.
- Ask your provider what they’ll be doing to minimize tearing. Most will use some type of oil or lubrication to gently massage and stretch your perineum as your baby emerges.
I know this is uncomfortable to think about. Try to remember that your body know what she’s doing, and if she needs help, she’ll let us know. You CAN do this.
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