Intimate Wellness Institute

Vaginal Tears During Childbirth

A vaginal tear (laceration) is an injury to the tissue around your vagina and anus that can happen during childbirth. The severity and location vary and the damage is commonly inadequately corrected at the time of delivery.

What is a vaginal tear?

A vaginal tear often happens during childbirth. The most common location for a tear is the perineum (the area between the vagina and the anus).  However, tears can occur in other places as well including the urethra (where you urinate), the labia (lips of the vagina) and the clitoris.

As high as 90% of women with a vaginal delivery will have some tearing.  Treatment for vaginal tears depends on the severity and location of the tear. Due to the circumstances and tissue changes these tears are rarely well addressed at the time of delivery.  

What are the four degrees of perineal laceration?

There are four different grades of perineal vaginal tears. The grade determines the potential damage.

  • First-degree tear: This is a superficial tear and usually heals well on its own.
  • Second-degree tear: This is the most common degree of obstetrical tear. This type of tear extends through your skin and into the underlying connective tissue, pelvic floor (kegel) muscles of your vagina and perineum to the anus. This type of tear can cause permanent damage to your vaginal tone, pelvic support, sexual function and bladder function.
  • Third-degree tear: A third-degree tear extends from your vagina to your anus. This type of tear involves injury to the skin, connective tissue and muscles of your pelvic floor and perineal area, as well as tearing through your anal sphincter muscle. These muscles provide bowel control. This type of tear will have all the potential issues of a second degree tear as well as trouble controlling your bowels and gas.  
  • Fourth-degree tear: This type of tear extends from your vagina, through your pelvic floor and perineal area, and anal sphincter muscles and all the way into your rectum.  This injury is the most severe type. This type of tear has the highest risk for permanent bowel, urinary and sexual issues.

As most tears are fixed at the bedside after delivery poor functional and cosmetic results are common.


What causes a vaginal tear during childbirth?

Some factors that increase your chance of tearing include:

  • First delivery.
  • Position of the baby.
  • Operative or Assisted Vaginal delivery – Use of forceps or a vacuum during delivery.
  • Size of the baby.
  • Prolonged labor.

What are the potential complications of vaginal tears?

Vaginal tears can be uncomfortable and painful, but most small vaginal tears heal within 6 weeks. For more significant tears permanent skin, muscle and nerve damage can be an issue.

Some of the common long-term complications of more severe vaginal tears include:

  • Painful intercourse or Dyspareunia.
  • Urinary Incontinence.
  • Fecal incontinence (leaking stool)
  • Ongoing pain and soreness.
  • Vaginal laxity and loss of sensation during intercourse.
  • Orgasmic dysfunction – losing the  ability to have an orgasm or becoming more difficult.

If you are experiencing any of these complications after delivery contact The Intimate wellness Institute for help.

How are vaginal tears treated or repaired?

Unfortunately, vaginal injuries with delivery are often ignored, considered normal, and inadequately evaluated and treated.  At the Intimate Wellness Institute we take these issues seriously.  Dr.  Guerette and the IWI team will listen to your issues, properly evaluate the situation and correctly treat the problem.  Often the evaluation involves some simple office tests to assess the degree or urinary and bowel damage.  Once the issue is understood Dr. Guerette will consult with you to develop a plan.  Common options for care include:

  • Advanced Pelvic Floor Therapy with a therapist or Emsella
  • Laser or Radio Frequency vaginal tightening
  • Vaginoplasty/vaginal tightening
  • Numerous methods to improve bladder and bowel control.

The Intimate Wellness Institute has the most comprehensive options for overcoming obstetrical injuries in the region.

Vaginal tears and obstetrical trauma are extremely common and often have lifelong consequences affecting your bladder and bowel control, sexual function, and confidence.  These issues are often completely ignored or inadequately addressed in traditional women’s healthcare.  At The Intimate Wellness Institute we understand how important and devastating these issues can be and we will listen to you and work with you to get you back to yourself.