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Taking Care of Vaginal Tears After Delivery

What are vaginal tears?

Vaginal tears are common during childbirth. They occur when your baby’s head is too large for your vagina to stretch around. Women at a higher risk of vaginal tears include:

  • first-time mothers
  • mothers whose babies have a high birth weight
  • mothers who had a long delivery
  • mothers who had assisted birth, such as with forceps or vacuum

Tears can heal within seven to 10 days with appropriate treatment. However, you can be sore for a few weeks afterward.

Depending on the severity of the tear, you may receive stitches or prescriptions for medicated creams and ointments.

Home treatment methods

You can expect some discomfort, bleeding, and swelling following delivery and a vaginal tear. With your doctor’s permission, there are ways you can relieve this discomfort at home and encourage healing. These include:

Applying ice packs

Applying ice packs to the affected area for 10 to 20 minutes at a time can help reduce swelling. Many drugstores sell ice packs that resemble sanitary pads that are “snapped” to release materials that turn cold. These can be worn in your underwear. If you use an ice pack, ensure it has a clean cloth cover over it to protect your skin from damage from the cold.
Make sure not to use an ice pack for more than 20 minutes at a time, as it can cause nerve damage.

Taking a stool softener

Your doctor may prescribe a stool softener or recommend an over-the-counter stool softener, such as docusate sodium (Colace). This will reduce your need to strain when you have a bowel movement. You shouldn’t resist a bowel movement if you feel the urge to go, as it can lead to constipation.

Staying clean and dry

Your doctor will likely provide a squeeze bottle or sitz bath so that you can keep the perineal area moist and clean after delivery. You can put lukewarm water in a squeeze bottle and use it as a rinse after going to the bathroom. Sitz baths are small, plastic tubs that fit over a toilet bowl. You can fill the bath with lukewarm water and sit in it for a few minutes to cleanse your skin.

Resting

It’s hard to rest when you have a new baby, but avoiding strenuous exercise can help you to heal. Your doctor will likely recommend that you avoid strenuous activity for at least two weeks after giving birth. If you have family and friends who are offering to help, accept it, and stay off your feet as much as possible.

Avoiding activities known to worsen your symptoms

These include avoiding salt baths, talcum powder, and perfumed lotions. You also shouldn’t apply hot water or hot packs to your perineal area. You should avoid squatting to keep from stretching the skin too much. Sexual activity should be avoided until healing is complete.

Your doctor may give you additional instructions, depending on the type and severity of your tear. They’ll also tell you what symptoms indicate that you should call their office. These include:

  • foul-smelling discharge
  • increased pain at the incision site
  • fever
  • significant swelling

Complications

Though vaginal tears can be painful and unpleasant, most are able to heal with rest and a combination of home remedies or treatment by a physician.

Severe tears are called third degree and fourth degree lacerations. A third degree laceration is a tear that extends through vaginal tissue, perineal skin, and perineal muscles that extend into the muscles around the anus. A fourth degree laceration extends to the anal sphincter and the tissue beneath it. These severe tears can cause problems with incontinence later.

Infections are possible, but are unlikely if you’re receiving proper treatment. Signs of infection from vaginal tears include fever or stitches that smell or become painful.

You should contact your doctor if:

  • you have symptoms of an infection
  • you have trouble controlling your bowels after a severe tear
  • you have intense pain while urinating, or increased frequency of urination
  • your sanitary pad is soaked with blood or you’re passing large blood clots
  • you have severe pain in your lower abdomen, vagina, or perineum

What is the outlook?

Vaginal tears, though unpleasant, are a normal complication of childbirth for many women. While some will need to be treated by a doctor and may require stitches, plenty of women are able to treat their vaginal tears with home remedies like those listed above, and can lessen the likelihood of experiencing a tear by taking additional precautions.

Make an appointment with your doctor for additional treatment if you’re experiencing unexpected bleeding, pain, or vaginal swelling following birth, or if your vaginal tear isn’t healing or is getting worse.

Preventing vaginal tears

Sometimes vaginal tears are unavoidable, but there are precautions you can take to help prevent them during delivery. These precautious include:

  • practicing Kegel exercises ahead of time to strengthen the pelvic floor
  • taking prenatal vitamins, eating a balanced diet, exercising regularly, and maintaining overall good health
  • using a lubricant when it’s time to push, as this decreases friction and likelihood of tearing
  • keeping the perineum warm to increase blood flow and soften the muscles (you can place a warm towel on the perineum to accomplish this)

If you’re concerned about vaginal tearing or at increased risk, consult your doctor before birth to ask how to lessen the chances of it occurring. 

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