Tearing during Delivery

A common result of vaginal birth is perineal tearing.  The perineum is the tissue between the vaginal opening and the anus.  This tearing typically happens as the tissues are stretched by the baby’s head and shoulders during delivery.  These tissues are also cut when a birthing mom has an episiotomy.

Tears are graded into four categories:

• Grade 1 - tearing just to the skin of the perineum

• Grade 2 - tearing to the skin and pelvic floor muscles of the perineum

• Grade 3 - tearing of the skin and muscles to but not completely through the anal sphincter

• Grade 4 - tearing completely through the anal sphincter

These tears are a main reason why new moms receive stitches following delivery.  However, recovery from this tearing can be complicated, depending on the grade.  Some women have pain and restriction around their scar site. These are caused by scar tissue fibers sticking together and not gliding like the other tissues around it. Scar tissue also has many highly sensitive nerve endings to protect the healing tissue, making touch or stretch to the scar painful.  Some women have incontinence (urinary and/or fecal) due to the injury to the pelvic floor muscles and anal sphincters.  Still others have pain or fear with using the bathroom.  Sometimes intercourse can be painful due to the scarring.

The good news? The vast majority of this is treatable using pelvic physical therapy. In pelvic PT, new moms learn how to desensitize and mobilize the scar tissue to decrease pain and increase flexibility of the tissue, increase pelvic floor strength to curb incontinence and urgency, and strategies for coping with symptoms while eagerly awaiting healing.

Want to add these techniques to your toolbox? Want more tips on postpartum care?  Contact South Shore Pelvic Health to set up a telehealth evaluation. It’s never too early (or too late!) for postpartum healing!