Second-degree tear: This second level of tearing is the most common. The tear is slightly bigger, extending deeper through your skin into the underlying muscles of your vagina and perineum. This tear requires stitches. Third-degree tear: A third-degree tear extends from your vagina to your anus.
Second-degree tears involve skin and muscle in the area between the vaginal opening and the rectum. These tears may go deeper into the vagina. Second-degree tears typically require stitches. That often can be done in the delivery room.
It's most painful at the beginning, but you should feel better each day. Pain typically affects sitting, walking, urinating, and bowel movements for at least a week. Your first bowel movement may be painful. A tear is usually healed in about 4 to 6 weeks.
Degrees of perineal tears
There are 4 degrees of tear, depending on how deep they are and how far they go: First-degree tears are small and skin-deep. Second-degree tears are deeper and affect the muscle of your perineum. Third-degree tears also involve the muscle that controls your anus (the anal sphincter)
These are tears affecting the muscle of the perineum and the skin. These usually require stitches. The repair is normally done using local anesthetic in the room where you had your baby. Second-degree tears are unlikely to cause long-term problems, but they can be very sore.
Second-degree tears are repaired in three stages – first the vaginal tear, then the perineal muscles, then the perineal skin – but using one continuous stitch, so it isn't really possible to answer the question “how many stitches”!
Pour warm water over your vagina and perineum after going to the toilet, and always wipe from front to back to keep your stitches clean. To relieve pressure on the wound, hold a clean pad and press lightly against your stitches while you go for a poo. (RCOG, 2015; NHS Choices, 2017)
Sleep on your side, and try not to stand or sit for long periods of time, which can increase perineal pain.
Wiping can be especially painful, so try to stick to the spray and blot method for at least a week after birth.
What is the most common type of tear during childbirth? A second-degree tear is the most common. It involves the first layer of your perineal skin and some of your perineal muscle. Only about 5% of people have third- or fourth-degree tears.
Take away: One study shows that epidurals increase the risk of tearing. Another says that the reason more tearing occurs with epidurals is that more first time moms choose epidurals and first vaginal deliveries are already associated with a higher risk of tearing.
A grade 1 MCL tear (minor tear) can usually heal on its own with rest within one to three weeks. Grade 2 and grade 3 MCL tears, which are more severe, need proper treatment in order to heal, which can include resting, wearing a knee brace and doing physical therapy.
The rate of second-degree perineal tears, which involves the vagina and/or perineal muscle, has been reported to be 35.1–78.3% among primiparous women and 34.8–39.6% among multiparous women [1–3], while third- and fourth-degree tears, which involve varying degrees of injury to the anal sphincters, occur in 5.1–8.3% of ...
But many variables can affect how much lubrication your body produces. And if there isn't enough natural moisture created, tearing can occur. “Vaginal dryness is often part of the problem, because dryness creates friction, and that's the main reason the tears and abrasions occur,” says Dr. Evins.
Long term complications include pain, urinary or anal incontinence, and delayed return to sexual intercourse due to dyspareunia. [1][3] These symptoms are worse in women who had an episiotomy compared to those who were allowed to tear naturally. [2] Flatal incontinence can persist for years after an OASIS.
Resist sitting with crossed legs, or any sitting position that allows your labia to gape open, if you have a tear or stitches. This assists to reduce strain on your perineum or stitches. Practice several very gentle pelvic floor “pulses” each hour without trying to “hold”.
It is rare for the stitches to simply to come undone. However, occasionally an infection or pressure on the stitches from bleeding underneath can cause the stitches to breakdown, leaving an open or gaping wound. This is called perineal wound dehiscence, or breakdown.
If you've had stitches or a tear, doing a poo won't make the tear any bigger, or make your stitches come away. It's understandable to feel vulnerable about this part of your body. Feeling tense will make it harder for you to do a poo, though.
Stitches or staples.
If you have stitches due to a torn or cut perineum (see “Perineum soreness,” above), it will take 7-10 days to heal. The stitches will absorb over time. It is important that you keep the stitches from getting infected by gently cleaning them with warm water after each time you use the toilet.
Having a shower and simply letting the water and mild soap run over the incision area is enough to keep it clean. Don't scrub it in the shower and when drying off, don't rub the incision. Instead, gently pat dry with a clean towel.
Yes, slightly. Women with a previous 3rd degree tear have approximately double the risk of another 3rd degree tear with their next baby. However, even doubling the risk means that 90%+ of women with a previous 3rd degree tear will have a very straight-forward delivery requiring minimal stitches in their next pregnancy.
First- and second-degree tears
This grading is applied whether your laceration occurs as a result of natural tearing or from an episiotomy. First-degree is a tearing of the surface layer of vagina only. Second-degree lacerations involve the underlying muscular perineal tissue.