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Why Do You Tear During Birth?

Why Do You Tear During Birth?

During a vaginal delivery it is possible that the perineum (the skin between your anus and vagina) will tear. But why do you tear during birth, and can anything be done to stop it?

Why do you tear during birth?

Tearing during childbirth is a natural occurrence. Most women will tear to some extent if they have a vaginal delivery, although most will have a small tear that just involves the perineal skin and muscle. A small number will have a deeper tear that runs into the anal sphincter.

Perineal tears happen because the baby's head and shoulders cannot fit through the vaginal opening. The cervix and the vagina will dilate and stretch during birth. But sometimes the vaginal opening is not wide enough and the baby's head and shoulders will exert so much pressure on the perineum that it rips.

Can anything be done to stop tearing during birth?

It is hard to predict when a tear will happen, which in turn makes it very difficult to prevent a tear. There are risk factors that make a tear more likely, including:

  • First time vaginal delivery
  • Assisted delivery (forceps or ventouse)
  • Epidural
  • Long second stage of labour
  • Larger than average baby

Very few of the above can be predicted before the start of labour, so you cannot tell who will tear and who will not.

It has been suggested that massaging the perineum during pregnancy can help to increase elasticity. It may also be beneficial to apply a warm compress to the perineum during the delivery, as this will support the perineum, while the warmth will relax the muscles.

What will happen if I do tear?

If you do tear, it will be detected during a routine examination that takes place after the birth. If it is a small tear, the injury will be repaired by either a midwife or doctor in the delivery suite. If the tear extends down into the anal sphincter complex (meaning either a 3rd or 4th degree tear), you will be taken to theatre to be sutured by a surgeon.

After the repair, you will be given advice about keeping the wound clean and pelvic floor exercises. If it is an extensive tear, you will also be given antibiotics and laxatives to promote the healing process.

What will happen if my tear is not repaired?

It is important that your tear is repaired, otherwise a defect will remain in your perineum and possibly even your anal sphincter. This will be painful and will make bowel control very difficult. It is negligent to fail to diagnose and repair a perineal tear, so if it happens to you, you could be entitled to pursue a compensation claim. Contact us for more information.

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