Tearing and episiotomy jargon

[Jellymaker]

Ok Ladies,

I have read all the benefits of tearing naturally over having an episiotomy, but all the stuff i've read on tearing is a little confusing. What is the difference between a graze and a tear and what are the different degrees, 1st, 2nd and 3rd? Are we talking tearing up the length of the vagina inside? Tearing outward externally?(labia etc,) or tearing into pelvic floor muscle?

I'm not trying to scare myself but would like to know what all the lingo means.

Help anyone? It may be TMI but i would like to know specifics.

[Mildez]

A graze is a graze basically. Its where the top layer of skin gets riped off. These hurt as much if not more as its the top layer where the nerve endings are.
A first degree tear is only a short laceration to the perineum and involving the skin.
A second degree tear damages the skin and muscle of the perineum so its much deeper and usually longer. A second degree tear can extend all the way to the anus but not through it or into the sphincter.
A third degree tear involves the skin, muscle of the perineum and the anal sphincter. This is much more nasty and not common. Often a third degree tear is from an episiotomy that has extended through the anus (again uncommon)
A graze can also need suturing although usually not. Some first and even second degree tears don't need suturing although most second degree tears are sutured. It all depends on how the skin comes back together. If its gapping or can only been seen if pulled open and if its bleeding. A tear that sits together normally and doesn't bleed sometimes wont be sutured.

[Mummato2]

:yeahthat:

Brilliantly summarised

[Linzy]

Aha! I was a little confused, I had an episiotomy with my son (36 stitches - 3 rows of 12) and the scar goes from the bottom of my fufu to my butthole. I had to sit in salty water every couple of hours, and hold a maternity pad against my stitches when having a poo. I took anti inflammatories for the pain..but to be honest I wasn't in agony or anything, it was more uncomfortable than anything. I found sitting on a rolled up towel (like a donut) helped alot. I was too busy ogling my new born and feeding to feel the stitches. I have always wanted to know what a 'normal' amount of stitches for an episiotomy is but can't find out that information. The ob's and midwives just ignore that question and move on to the rest of the labour questions.

As for the tearing, I only found out this pregnancy that I also tore. My doctor told me while she was doing an internal. And it is on the inside of my fufu extending to the outer area. This is wear I have all this blue/purple swollen lumpy bits that ache from time to time so I don't know what happened there. I didn't even know I had one but it certainly explains the lumpyness this pregnancy..I thought I was prolapsing!

As a result of the epi and the tear I was already considering a c section this time to escape any possibility of it happening again. Even though I know it's not always the case. But in the end I had other reasons that convinced the Ob to do a c section this time. Now I get to feel how much a c sections hurts to recover from, I have heard it can be a more painful recovery than an epi or tear!

And they call us the weaker sex... If a bloke had a rip in his ball bag you'd never hear the end of it and the tear would gradually get larger with everytime the story was told.

[Mildez]

Linzy I agree on the man thing increasing the size of the whole in his ball bag.

As for how many stitches for an episiotomy that is a difficult one to say. I haven't seen any vaginal suturing done is seperate sutures so to speak (for birth trauma) the dr's were I work all do a continuous suture like a coil if that makes sense. Because they loop from one to the next it would make it difficult to count them and perhaps why you can't find an average amount of sutures in any research you might have looked for. Depending on how deep the laceration depends on if you need more then one row of sutures. Like one for the muscle and then another for the skin on top of the muscle. You can also tear inside and have what is describes as an intact perineum so no tearing from the exit of the vagina to the anus. Thats why after birth the Dr or midwife usually inserts a finger or two and a clean clothe to look for internal trauma that can't be seen from the outside.
I think in comparison to the birth the sutures or trauma usually aren't bad. A bit uncomfortable. I know with mine they were very tender and it really stung to pee but mine were up around the urethra not down the bottom.

[Linzy]

Linzy I agree on the man thing increasing the size of the whole in his ball bag.

As for how many stitches for an episiotomy that is a difficult one to say. I haven't seen any vaginal suturing done is seperate sutures so to speak (for birth trauma) the dr's were I work all do a continuous suture like a coil if that makes sense. Because they loop from one to the next it would make it difficult to count them and perhaps why you can't find an average amount of sutures in any research you might have looked for. Depending on how deep the laceration depends on if you need more then one row of sutures. Like one for the muscle and then another for the skin on top of the muscle. You can also tear inside and have what is describes as an intact perineum so no tearing from the exit of the vagina to the anus. Thats why after birth the Dr or midwife usually inserts a finger or two and a clean clothe to look for internal trauma that can't be seen from the outside.
I think in comparison to the birth the sutures or trauma usually aren't bad. A bit uncomfortable. I know with mine they were very tender and it really stung to pee but mine were up around the urethra not down the bottom.

Ahhhhh this makes sense now! I don't know where I got 36 stitches or 3 rows of 12 from, must have been my ex partner as it's not on my records either. Thanks for that

[Mummato2]

And they call us the weaker sex... If a bloke had a rip in his ball bag you'd never hear the end of it and the tear would gradually get larger with everytime the story was told.

[Cass72]

A graze is a graze basically. Its where the top layer of skin gets riped off. These hurt as much if not more as its the top layer where the nerve endings are.

:yeahthat: I had some grazing (as the doc so elequently put it!) which hurt way more than my epi. FWIW I remember them saying to me that they were going to snip but with everything else going on I didn't notice.

Also, if you do end up with stitches, the whole "holding it while you poo" (thanks Linz - almost forgot this one!!) is a really really really good tip that my sister gave me!!