All You Need to Know About a Vaginal Tear

Let’s be real. The words “vagina” and “tear” are not two words that any woman wants to see in the same sentence.

Still, it’s very common to get a vaginal tear (also called a perineal tear) when you give birth, and there are other ways it can happen.

Your body is amazing, and while a tear is scary at the time, you will heal.

Here’s our guide to the degrees of vaginal tearing that can happen, the causes, and how to look after yourself as you recover.

In this article: 📝

What is a vaginal tear?

A vaginal tear is an injury to your vagina that can extend along your perineum (the skin between your vulva and anus). [1]

In rare cases, vaginal tears can also affect the muscles inside your rectum.

Doctors talk about degrees of vaginal tearing to explain how severe the injury is and what treatment it needs. Let’s start by taking a deep breath and looking at these in more detail:

• Graze: A graze means that the skin is damaged but not torn.
• First-degree vaginal tear: First-degree vaginal tears involve both the skin of the perineum and the skin of the vagina.
• Second-degree vaginal tear: These tears extend beyond the skin, deeper into the muscle of the vaginal wall and the perineum.
• Third-degree vaginal tear: This involves the vagina, the perineum, and the muscle around the anus.
• Fourth-degree vaginal tear: Fourth-degree tears are the most severe (and also, happily, the least likely to happen). They affect the vagina, perineum, anus, and extend into the wall of the rectum.

What causes a vaginal tear?

Vaginal tearing can happen at different tiers and in different ways.

Fortunately, most vaginal cuts tend to be minor and not medically serious.

Let's dive into the two main causes in deeper detail:

Tearing during childbirth

Most vaginal tears happen during childbirth. Your doctor or midwife will do everything they can to try and minimize tearing.

This is the reason they might hold a warm compress to your perineum while you push or get you to pant through contractions—it’s all to encourage your skin to stretch.

But birth is unpredictable, and tears are still very common.

Up to 90% of first-time mamas have a graze, tear, or episiotomy (where the skin of the perineum is deliberately cut to prevent a tear from happening). [2]

Even outside of this, there's a lot going on for your vagina after birth.

The good news? Only 1-3% of women suffer a third- or fourth-degree tear. [3]

If you do tear, it’s really important to remember that it’s very common and definitely not your fault.

Vaginal tears during birth are more likely if:

• This is your first vaginal birth
• Your baby arrives quickly (i.e. you have a very short second (pushing) stage of labor
• Your baby is in a face-up or back-to-back position for delivery
• Your doctors need to use forceps to help you deliver your baby

Vaginal tears during sex

While some sports, especially horse riding and cycling, can cause vaginal injuries, the most common other main cause of vaginal tears is sexual penetration.

In particular non-consensual sexual activity, accidents, and lack of lubrication. [4]

Although they’re usually more minor than tears from childbirth, vaginal tears after sex can still sometimes need stitches and plenty of time to heal.

And depending on the cause, that may include mental and emotional healing—something you do not need to do alone (we've links to support that can help.

If you notice the pain getting worse or you're struggling to cope, seek professional help immediately.

Whether physical or emotional, a trauma is a trauma, and it deserves care. ❤️

Vaginal tear treatment

Doctors treat vaginal tears by repairing the damaged skin and muscle.

Grazes and first-degree tears are the easiest to treat and may not even need stitches.

Because second-degree tears involve several layers of tissue, they do need to be stitched (don't worry, this is not a "husband stitch" which is now rightfully illegal).

If it’s an injury from childbirth, though, this can usually be done under local anesthetic in the delivery room.

More third- and fourth-degree tears are repaired in the OR under general anesthetic because it’s a specialist procedure.

If you’ve torn badly, you might also have physiotherapy to strengthen your pelvic floor after the procedure.

These exercises will also help if you have any incontinence and will help to bring back the feeling “down there”.

How long does it take a vaginal tear to heal?

It’s hard to give a definite answer here because your recovery time depends on how severe the injury was. And, of course, every woman’s body is different and will heal in its own time.

After a first- or second-degree tear, you’ll probably feel better once your stitches have dissolved and be pretty much back to feeling like yourself again by your postpartum check-up.

For more severe tears, you may need several months of rest, healing, and physiotherapy before you fully recover. In very rare cases, your doctor might recommend further surgery to fully correct the injury.

The long recovery process can be very frustrating, especially if you’re trying to look after yourself while caring for a newborn baby.

Thankfully, there are some things that you can do to help or at least to make yourself more comfortable as you get better.

How do you heal a tear down there?

Treatment for vaginal tear can also be done at home. Here are the small steps that can make a big difference to your recovery:

• Rest: Not so easy when you have a newborn, but sleep speeds up healing. Don’t be afraid to ask for help and support from your partner, family, or friends to make sure you get a chance to rest.

• Healthy eating: Recovering takes energy, so eating lots of healthy food will help your body do its job.

• Increasing water intake: Especially for a third or fourth-degree tear. Drinking 2L of water a day can help make passing stools easier, preventing constipation. [3]

  And here’s how to look after yourself while your body heals:

• Cushions, cushions, cushions: Perching on a pillow, a hemorrhoid ring, or even a pool ring will take the pressure off your stitches.

• Ice it up: Sitting on a covered ice pack can be soothing and can also help if your stitches are itchy. Itching means healing, but it’s really uncomfortable at the time.

• Keep it clean: Use a peri bottle when you go to the bathroom and squirt water onto your vulva while you pee. This will stop your urine from burning. Afterward, pat yourself dry with toilet paper instead of wiping. [5]

• Take a dip: Sitz baths are shallow, cool baths where you soak your bottom for 10-15 minutes to reduce pain and swelling. Most doctors would recommend that you avoid full baths until after your stitches have completely healed.

• Take medications: Pain relievers can reduce inflammation and make you feel more comfortable, helping you to rest well. Stool softeners or laxatives can also save you from straining your stitches when you “go”. Just be sure to ask your doctor about what medications you can take, especially if you’re breastfeeding.

Vaginal tear complications

So what happens if a perineal tear is left untreated?

It depends on how severe the tear is. Usually, a minor vaginal tear will heal quickly without treatment—and that can include a first-degree tear. [6]

But a second-degree tear often requires stitches (more on this below).

Common perineal tear healing complications are bleeding and pain. [7]

More long-term complications can look like anal or urinary incontinence and painful sexual intercourse.

Of course, the biggest risk is infection. To be on the safe side, it's best to keep an eye out for possible symptoms like:

• Constant pain
• An unusual smell
• Swollen, red skin
• Pus-like discharge

If your bleeding or pain gets worse or if you spike a fever, call your doctor immediately.

Outside of this, whatever the reason for your vaginal tear, give yourself time, be kind to yourself, and trust that you won’t feel like this forever.

It’s crazy that even though it’s very common, tearing can still be a taboo subject.

If you ever feel alone in your recovery, you can find other women in the Peanut community who’ve been through the same thing and can give you some extra support.