Second Degree Perineal Tears During Birth – 4 Things To Know

Second Degree Perineal Tears During Birth - 4 Things To Know

My first birth was pretty much textbook – with no real complications. I needed only a few stitches to heal up my perineum.

When it was time to give birth to my second baby, I knew tears tended to heal quite well. Even so, I was worried about tearing during childbirth.

Thankfully, my fears were unfounded.

For many pregnant women, though, the possibility of vaginal and perineal tears frequently tops the list of their concerns.

Second Degree Perineal Tears During Birth – 4 Things To Know

There is some good news about perineal tears. Although there is tearing in 90% of births, the vast majority of tears are minor. This means even if you experience tearing, chances are it will heal very well, even if a few stitches are necessary.

More good news. There are things you can do to reduce your risk of tearing, and the severity of perineal tears during birth.

What Is A Second Degree Perineal Tear?

The perineum refers to the region between the vaginal opening and the anus. This area and the vagina are well designed to allow for a baby to be born, typically with little to no physical trauma.

Sometimes, the baby’s positioning or its size, a mother’s birthing position or anatomy, birth interventions, or other factors cause vaginal and perineal tearing. It is usually minor, and very rarely severe,

Tears are classed as first, second, third and fourth degree tears. First degree tears are the least severe.

A first degree tear involves only perineal skin or the first layer of vaginal tissue. A second degree tear involves the same area but also some muscle tissue.

Here’s what you need to know about second degree tears:

#1: Second Degree Tears Typically Heal Within A Few Weeks

While it sounds scary to know you can tear muscle tissue, the good news is it is less serious than it sounds.

There can be pain and discomfort, but not significantly more than what most women feel in the immediate postnatal period. Resting, and giving your body time to heal is often all you need do to cope with a second degree tear.

The best advice is to take a few weeks after childbirth to rest and heal. Prolonged pelvic floor complications are sometimes the result of not giving your body adequate time to heal.

The need to rest is a positive. It’s excellent for your entire body, and for your emotions. Lots of time spent resting at home is great for bonding, and your baby will benefit too.

Be sure to read Why You Should Have A Post-Natal Month After The Birth to learn about additional benefits to making rest a priority.

#2: Second Degree Tears Require Stitches

A second degree tear requires stitches for optimal healing. Stitches in the skin and muscle tissue will make sure everything heals properly. Stitching also prevents excess scar tissue.

Typically, you will have dissolvable stitches. This means they’ll gradually come out as you heal, and you won’t need an additional appointment to have the stitches removed.

After the third stage of labour, which is when the placenta is expelled, you’ll be examined for tearing. In the case of a second degree tear, you’ll be prepped and stitched shortly afterwards.

If you’ve had an epidural, sometimes the area will still be numb, and extra medication won’t be needed. If your epidural has worn off, or if you’ve had a natural unmedicated birth, you’ll receive a couple of injections of local anaesthesia.

Administering local anaesthesia might be a bit uncomfortable, but you shouldn’t feel any of the stitches. For most women, having a new baby in their arms provides a wonderful distraction and lots of oxytocin.

#3: There Are Many Options To Help Relieve Pain Or Discomfort

Whether you experience tearing during childbirth or not, like most women you’ll experience at least a little discomfort in the postnatal period. After all, your body just grew and birthed a human being (no small feat), so it’s not a huge surprise.

Fortunately, there are many things you can do to find relief from any postnatal ailments.

Many women find these thing helpful:

  • Herbal or Epsom salt soaks
  • Applying witch hazel
  • Ice packs or cool compresses
  • Adequate rest, and lots of time off your feet
  • Using a peri-bottle, and dabbing rather than wiping after using the toilet.

Be sure to read 6 Ways To Heal Your Perineum After Giving Birth for more ways to help healing after a second degree tear.

#4: There Are Things You Can Do To Reduce The Risk Or Severity Of Tearing

It seems some tearing could be considered ‘normal’, given the high number of women who experience minor tears. The idea of tearing can be scary, but overall, it’s rarely a significant problem for birthing women.

Many women find it helpful to know the way they give birth can reduce the risk and severity of perineal tears.

This means you don’t simply have to hope you won’t have a severe tear; you can actively reduce your risk. And, if you still experience a tear, it might be less severe than if you had not tried to reduce the risk.

Some things you can do to reduce the risk of tearing:

  • Decline an episiotomy that isn’t medically necessary; (in rare instances, it is medically necessary)
  • Give birth in a position that doesn’t create extra pressure on your pelvic floor and perineum (e.g. assisted squat, upright positions, on all fours, etc.)
  • Strengthen your pelvic floor muscles with exercise during pregnancy.
  • Use a warm compress to help blood flow, and provide perineal support during pushing.
  • Breathe baby out rather than push as hard as you can with directed pushing; push only when your body feels the urge.

Be sure to read Tearing During Birth – 9 Ways To Help Prevent Tearing for more tips on reducing the risk or severity of tearing.

While the thought of tearing is always unpleasant, in reality it’s rarely problematic. For most women, any tearing will have healed after the first six weeks of the postnatal period.

For a few women, the problems might persist. If you experience persistent pain beyond the normal healing period, be sure to talk to your midwife or doctor, or reach out to a pelvic specialist.

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Maria Pyanov CPD, CCE CONTRIBUTOR

Maria Silver Pyanov is a mama of four energetic boys and one unique little girl. She is also a doula and childbirth educator. She's an advocate for birth options, and adequate prenatal care and support. She believes in the importance of rebuilding the village so no parent feels unsupported.


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