How to Prevent Vaginal Tearing in Pregnancy
Even in the best of circumstances in childbirth , the vagina usually ends up with a few battle scars. The majority of vaginal tears are minor, but severe tearing and complications can also occur. You might be considering childbearing if you are interested in learning more about the various types of vaginal tears, what can cause it, how to avoid bad tearing and how to treat it.
Types Of Vaginal tearing
Up to 80% percent of women will experience some amount of vaginal tearing at the time of delivery. The majority of vaginal tearing will not cause any serious problems. While mild tear can cause pain at first, most tears heal within 4 to 6 weeks. They don't usually cause long-lasting side effects. More severe tears that go from the vagina to the muscle around the rectum occur in 3% of deliveries; and tears that extend from vagina to through the rectum (the dreaded "vag-anus" tear) occur in ~1% of vaginal deliveries.
Long-term pain can be caused by tears that go beyond the rectum into the rectum. These tear may also lead to difficulty in controlling stool, nausea, or discomfort, as well as bowel problems. Although these problems can be fixed with therapy and extra surgeries, there are times when they cause persistent issues.
How To Prevent Vaginal tears
Probably the most significant thing you can do to reduce your risk of severe vaginal tears is to ask your doctor to avoid performing an episiotomy unless medically necessary. It had been thought that cutting the perineum, the skin between the vaginal and rectum, would protect the muscles from further injury and facilitate a controlled delivery. Now we know better that an episiotomy cuts more like a half-zipper. It makes it simpler to open the zipper fully and tear into the rectum when pressure is applied. There are some medical reasons episiotomy may be necessary (e.g. if the baby's heart rate starts to fall near the time of delivery). However, they are not routinely recommended. Thanks to these data, episiotomy rate has dropped 75% over 20 years.
Using a lubricant like mineral oil or KY jelly in the vaginal canal as the baby is delivered has been shown to help reduce tears as has applying warm, moist cloths to the perineum while pushing. Tears can be reduced by massaging the perineum muscles while you push. Perineal massage performed in weeks prior to delivery might be beneficial. However, the results of some studies are conflicting. It is possible that it may help. It has not been proven that the type and position of delivery have any effect on tear production.
While there are some strategies that have been shown to help reduce tears, my personal opinion is a lot of the time it comes down to the elasticity of a woman's vagina and the size and position of the baby. Some women have great skin that stretches well; others, not so much. Some babies are petite, in the right position, while others weigh 10 pounds and have their fists up to their faces, acting as superman but destroying their mother's vulva.
It has been demonstrated that forceps or vacuum can increase the likelihood of a severe tear. But, they are there to help avoid having to have a Cesarean section. This is also likely to lead to major Complications.
Caring For Your Vaginal tear
Most women describe the pain from their mild laceration to be an achy and burning type of discomfort for a couple weeks. The pain may be more intense in severe cases. It can take up to two months for the problem to resolve. Ice packs are a good option to reduce swelling and pain in the initial 24 hours. For the following weeks, "sitz baths", which can be used to provide additional relief for pain and swelling, may prove more effective. You can also soak in a warm, shallow bath. The majority of discomfort is relieved with anti-inflammatory drugs like naproxen or ibuprofen.
When performing bodily functions, be cautious. You will feel the small cuts in your skin caused by delivery due to the acidity of urine. To avoid this pain, you can use a squirt of water to dilute your urine while you pee. You can also find upside down bottles at local boxes stores if your hospital squirt is lost. These are easier to use. It is important to not constipate at any cost. It doesn't matter if your tear is not deep into your rectum, but it does help to make sure that you poo softly. The perianal skin can be pulled and stretched by hard stools, which will cause a lot of pain and pull at your stitches. To keep all things flowing smoothly, drink a ton of water, eat lots fiber (or whatever food 'helps you go"), and take in stool softeners daily (docusate sodium and polyethylene glycol are safe to take with breast feeding and usually do not cause diarrhea) until all is healed. Also, do not have sex until you confirm that your vaginal tear is completely healed.
When your tear ceases to be painful, then you may return to the kegel exercise program that helps strengthen your pelvic floor muscles. It is very common for women to experience significant incontinence in the weeks after delivery, but this should improve over time. You can talk to your doctor about pelvic rehabilitation or other options if your incontinence persists after your 6-week visit.
Vaginal tears are extremely common and usually heal completely within 6 weeks of delivery. The vagina is literally made to stretch and expand to accommodate the baby, but occasionally rigors of childbirth take their toll. Discuss with your doctor the best way to prevent tears after childbirth and how to best care for your bottom.