Is a vaginal tear as scary as it sounds?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

No. My perineum tore during birth, and I had no idea until they started stitching me up. And I didn’t have an epidural. But I get why women are horrified by the idea of a tear in one of the most sensitive parts of their body. It sounds awful. The thing is, the combination of a buildup of

endorphins, the numbness caused by the pressure of baby’s head, and the Goddess-like determination to get the baby out makes many women oblivious to a vaginal tear, regardless of whether or not they have an epidural.

To provide further insight about vaginal tears, here are answers to the most common questions I get about this topic:

How likely is a tear? It’s common for a first-time mom to tear, but again, you probably won’t even notice it until after birth. The recommendations in the “What to do” section can help reduce the likelihood of a severe tear.

How big are the tears? While tears range in size, they’re usually much smaller than we imagine. First-degree tears are only a few centimeters, while a fourth-degree tear (the most intense) is rarely longer than an inch.

How are tears repaired? Minor tears usually don’t need any repair beyond time and rest, while more extensive tears require absorbable stitches. The area will be numbed before the application of the stitches. In rare cases, anesthesia is used.

What is the recovery like? It’s not too bad — you just feel really sore for seven to ten days. Depending on severity, tears take anywhere from a few days to a few weeks to fully heal. The “What to do” section provides recovery tips.

What to do

To help the emergence of baby be a gentler experience for your perineum, thus minimizing your chance of a severe tear, follow all the suggestions in the “What to do” section from question  (the one about pushing). I would especially focus on the perineal tissue massage — make it your part-time job starting around week thirty-four or thirty-five of gestation. It’s one of the best things you can do to make your perineum more elastic and less susceptible to tearing.

If you feel the fear of a tear might hinder your ability to birth with calm and confidence, listen to this fear-release guided meditation: yourserenelife.wordpress.com/fear-of-tearing/. I also recommend envisioning your perineum as a rose that gently and easily opens. You can also watch time-lapse videos of flowers opening, focusing on how easily their soft petals unfurl — there’s no strain in their bloom. As you do this, remember that your perineum was also designed to soften and expand when it’s time to bloom.

In regard to what to do after a tear, here are a few strategies for soothing discomfort and promoting healing:

Kegels: Attempting Kegels (even if you can’t feel them) promotes circulation, which can speed recovery.

Sitz bath: Soaking your perineum in warm water can ease pain and itching. You can also ask your care provider if there are medications or additives you can put in the water to aid healing. If you’d rather not bother with sanitizing your bathtub, purchase a sitz bath kit that fits in the toilet and allows you to dunk your perineum. As an added bonus, a sitz bath also works wonders on hemorrhoids! Yay!

Witch hazel pads: These medicated pad liners — soaked in witch hazel extract— are the vagina’s best friend, offering instant cooling relief when slipped in the underwear.

Anesthetic spray: In addition to the witch hazel pads, ask your care provider to recommend an anesthetic spray to numb the perineum.

Fiber: Your first bowel movement after childbirth might be nerve wracking. I felt certain I would bust my stitches and poop out my innards — but I didn’t, and you won’t either. However, the essential act of clearing your bowels could be uncomfortable if you’re passing hard stools. Soften up that poo by eating fiber-rich foods and drinking lots of water. You can also ask your care provider if they recommend using a stool softener the first few days after birth.

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