Rinses, sitz baths, ice and medication can help the healing

Bringing a baby into the world is magical. The vaginal tearing that may come with it is less magical.

Your vagina and perineum naturally stretch during birth, but it’s not always wide enough for your arriving baby. As your newborn passes through, an obstetric tear may occur — especially if it’s your first delivery.

“Tearing is common and happens in more than 85% of births,” says Ob/Gyn Suzanne Young, DO. “Fortunately, most tears heal without any long-term complications.” 

Here’s what you need to know.

Vaginal tears during childbirth

What’s often called a vaginal (or obstetric) tear typically occurs in your perineum, the narrow area of tissue between your vaginal opening and anus. The perineum is part of your pelvic floor. Muscles and nerves in this area support your pelvic cavity and help you pee, poop and experience sexual arousal.

Childbirth also can cause tears to your vagina, vulva or anus.

Healthcare providers classify vaginal tears from first- to fourth-degree. First is the least severe, while fourth is the most severe. Here’s what each degree tear typically brings:

  • First-degree: Involves only the skin around your vagina.
  • Second-degree: Extends into the muscles of your perineum.
  • Third-degree: Spans the perineum to your anus.
  • Fourth-degree: Spreads through the sphincter muscles around your anus into your rectum.

Second-degree tears and higher may require stitches. Severe tears may require an operation for repair.

“Most perineal tears are first or second-degree,” says Dr. Young. “Third- and fourth-degree tears occur in less than about 10% of deliveries.”

How long does it take for a vaginal tear to heal?

Most vaginal tears feel better in a few weeks and heal completely by your six-weekpostpartum visit. “If you had stitches, they will dissolve during the healing process,” says Dr. Young. “You typically feel a little better every day.”

Sometimes, vaginal tears take longer to heal due to:

  • Infections: A bacterial infection may delay recovery.
  • Severity of the tear: Third- or fourth-degree tears may heal more slowly.

Home remedies to heal obstetric tears

There’s a lot to manage when you come home after giving birth. You’ve got a new baby and possibly other kids at home. But self-care is important, too — especially after an obstetric tear.

The main goals when caring for a vaginal tear are to:

  • Prevent infections.
  • Protect the area.
  • Relieve pain.

Dr. Young recommends these six steps to help you heal:

1. Rinse after using the bathroom

Keeping a wound clean is essential. Your care team at the hospital will give you a squirt bottle called a peri bottle designed for this purpose. Fill the bottle with warm water and gently rinse down below after you pee or poop.

2. Soak in a warm bath

Soaking in warm water promotes blood flow to the area to speed the healing process. The easiest way to do this is using a sitz bath, says Dr. Young.

A sitz bath is a basin you put on top of your toilet. Fill the basin with warm water and sit in it for a few minutes several times per day. You may receive a sitz bath from the hospital as part of your going-home care package. They’re also widely available online and in drug stores.

3. Pat dry

Aggressive drying can undo stitches and irritate healing tissue after a vaginal tear. Gently pat the area dry with toilet paper or a clean towel after using the bathroom, showering or using a sitz bath.

4. Ice for pain relief

Ice helps relieve pain and inflammation and is a standard treatment immediately after delivery. At home, ice your perineum using a:

  • Cold maxi pad from the freezer.
  • Postpartum ice pack.
  • Sealable storage bag filled with ice.

Make sure you’re using clean ice bags or packs. Anything unsanitary can introduce germs to the area and cause an infection.

5. Use pain medication

Over-the-counter medications can help relieve pain from vaginal tears. Try:

  • Oral pain medications like ibuprofen and acetaminophen.
  • Numbing spray (such as Dermoplast®) that you apply directly to your perineum.
  • Witch hazel pads that you place on a maxi pad.

For more severe pain, your provider may prescribe a stronger pain reliever.

“Most pain medications are safe to take while breastfeeding,” notes Dr. Young. “A very small amount of medication passes into breast milk, so we usually encourage women to continue breastfeeding.”

Let your provider know if you have any concerns about the safety of taking medications while breastfeeding.

6. Ease pressure when sitting

A vaginal tear may make sitting uncomfortable. Ease the pressure on your perineum by lying down or sitting on a soft surface. Specially designed donut pillows can also provide relief by shifting the weight from your perineum when sitting.

What to avoid if you have a vaginal tear

To speed the healing of a vaginal tear, try to avoid:

Constipation and straining

Constipation is a common problem after childbirth, but straining to poop can disturb the stitches in your perineum. If you have a vaginal tear, a laxative or stool softener can keep things moving smoothly.

“We often recommend taking over-the-counter laxatives right after delivery to prevent constipation,” says Dr. Young. “Once constipation occurs, it’s more difficult to treat.”

Drinking enough water and eating high-fiber foods such as fruits, vegetables and whole grains can also help you have regular (and less rock-hard) bowel movements.

Sex 

Healthcare providers generally recommend waiting at least six weeks after delivery to have sex. You may have to wait longer if you have a more severe vaginal tear.

“Ask your provider when it’s OK to have vaginal sex,” advises Dr. Young. “We want to make sure everything is well-healed before giving the green light.”

Strenuous activity

As a new parent, you have a lot on your plate. But taking it easy, especially during the first few days after delivery, can help start the healing process. Don’t push your body too hard.

When to call your healthcare provider about a vaginal tear

Make an appointment with your healthcare provider if you feel like your vaginal tear isn’t healing properly or something seems off. Signs of potential trouble include:

  • Fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher.
  • Foul-smelling discharge.
  • Heavy bleeding that soaks through a large maxi pad every hour for two consecutive hours.

Obstetric tears that don’t heal properly can lead to complications such as:

These problems can be difficult to talk about, but your provider can help. “We may recommend pelvic floor physical therapy or refer you to a pelvic floor dysfunction specialist (urogynecologist),” says Dr. Young.

Final thoughts 

Vaginal tears are common but treatable, reassures Dr. Young. If you have one, your healthcare provider will review care instructions with you before you go home. With proper treatment, tears usually heal without complications.

Just make sure to take time to care for yourself and your own healing in addition to any new baby duties.