Slide show: Vaginal tears in childbirth

Vaginal tears during childbirth are relatively common. Vaginal tears that involve only the skin around the vagina typically heal within a few weeks. Some vaginal tears are more extensive and take longer to heal. If the pain seems excessive or gets worse, contact your health care provider. Excessive pain could be a sign of infection.

First-degree vaginal tears are the least severe, involving only the skin around the vaginal opening. Although you might experience some mild burning or stinging with urination, first-degrees tears aren't severely painful and heal on their own within a few weeks. To ease any discomfort during urination, pour warm water over your vulva as you're passing urine.

Second-degree vaginal tears involve vaginal tissue and the perineal muscles — the muscles between the vagina and anus that help support the uterus, bladder and rectum. Second-degree tears typically require stitches and heal within a few weeks.

To ease discomfort while you're recovering:

• Sit on a pillow or padded ring.
• Pour warm water over your vulva as you're passing urine, and rinse yourself with a squeeze bottle afterward. Press a clean pad firmly against the wound when you bear down for a bowel movement.
• Cool the wound with an ice pack, or place a chilled witch hazel pad between a sanitary napkin and the wound.
• Take pain relievers or stool softeners as recommended by your health care provider.

Third-degree vaginal tears involve the vaginal tissues, perineal muscles and the muscle that surrounds the anus (anal sphincter). These tears sometimes require repair in an operating room — rather than the delivery room — and might take months to heal. Complications such as fecal incontinence and painful intercourse are possible.

To ease discomfort in the meantime:

• Sit on a pillow or padded ring.
• Pour warm water over your vulva as you're passing urine, and rinse yourself with a squeeze bottle afterward. Press a clean pad firmly against the wound when you bear down for a bowel movement.
• Cool the wound with an ice pack, or place a chilled witch hazel pad between a sanitary napkin and the wound.
• Take pain relievers or stool softeners as recommended by your health care provider.

Fourth-degree vaginal tears are the most severe. They involve the perineal muscles and anal sphincter as well as the tissue lining the rectum. Fourth-degree tears usually require repair in an operating room — rather than the delivery room — and might take months to heal. Complications such as fecal incontinence and painful intercourse are possible.

Your health care provider will evaluate your recovery at your postpartum checkup. If you experience complications from a severe vaginal tear, you might be referred to a urogynecologist, colorectal surgeon or other specialist.