Perineum tears are a reality that many, many folks face during vaginal birth.
Your perineum is the space between your vagina and your anus. When you get a perineum tear it will occur when you’re pushing your baby out of your vagina. Sometimes the skin doesn’t adjust enough or your baby has a larger head, and you tear.
The thought of a perineum tear might make you cringe, and believe me, I’m right there with you.
There are four degrees of perineum tears:
This is when the perineum tear only (I say “only” lightly, believe me) affects the perineal skin. This type of tear may or may not require stitches.
This is when the tear goes through the perineal skin and into the muscle (and possibly into the vagina). This tear usually requires stitches.
This tear goes from the vaginal opening to the muscle that surrounds the anus. It’s likely that you’ll require anaesthetic and surgery for this tear.
(Give me a second….this one’s a doozy…) This tear is fucked up, I don’t even understand how it is a thing, and I’m sorry to anyone who’s experienced one. This perineal tear runs from your vagina, through the anal sphincter, and into the mucous membrane that lines the rectum. This tear almost entirely will require surgical repair. Don’t worry, these tears are not common.
The healing time entirely depends on the degree of perineum tear you experience, your body, and your healing process.
Can you avoid perineum tears?
So, yes and no. There are ways that you can stretch your perineum while you’re pregnant like in this post about vagina yoga, however, there’s really no telling how big your baby’s head is going to be and how your body is going to respond to birth.
So, what does it feel like to have a perineum tear?
I tore with my first and second babies. They were second degree tears that required a few stitches. By my third and fourth baby, my vagina apparently learned her lesson and I didn’t have any tears.
I can’t say you’re going to “know” when you tore. When your baby is passing through the vaginal opening it hurts. It’s not called the ring of fire for nothing! The pain almost numbs the area so that if you do have a perineum tear you don’t really feel it happen, though.
I can’t speak to a third or fourth-degree tear, but I imagine it would make things more painful.
What happens after you have a perineum tear?
Again, depending on the degree of tear your recovery will look different.
For first and second degree tears you might need stitches. If this is the case you’ll receive a local anesthetic and then be sutured.
For a third and fourth-degree tear, depending on the severity, you may require a surgery to repair the tear. In this case, your healthcare professional will have a conversation with you regarding how to go about healing your perineum tear.
How can you recover from a perineum tear?
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-Use a peri-bottle instead of wiping. Pat yourself dry instead of wiping. Air dry if you can. Apply some perineum balm after you’re dried off.
-Eat lots of fibrous foods so that you don’t get constipated and feel the need to bear down
-Change your pad every 4 hours or so. Make sure that the adrea is clean.
-Leave your stitches alone. If you’re up to it, take a peek with a mirror because it’s kinda crazy cool that you have badass stitches that nobody (?) will get to see, but for the most part avoid touching them.