Vaginal Laceration

(Laceration, Vaginal; Vaginal Tears; Tears, Vaginal)

Definition

Vaginal lacerations are tears in the vagina or in the skin and muscle around its opening. Tears are most common in the space between the opening of the vagina and the rectum (perineum). The tear may be minor or very deep.

Causes

Deep tears may happen during vaginal delivery when:

  • Delivering a baby whose head is too large to fit through the vaginal opening
  • Going into labor too quickly
  • Having a delivery that is done with instruments

Minor tears may also happen during sex or from an injury to the crotch.

Risk Factors

Birth factors that may raise your risk are:

  • Having a very large baby
  • Having a baby for the first time
  • Having had tears with a prior pregnancy
  • Delivery with instruments
  • Baby's shoulder gets stuck

Other factors are:

  • Putting an object in the vagina
  • Thinning of the vagina

Symptoms

Vaginal tears cause pain and bleeding.

Diagnosis

The doctor will see tearing that happens to a woman giving birth.

A woman who is not giving birth will be asked about her symptoms and health history. A physical exam will be done. This is often enough to make the diagnosis.

Treatment

Talk with your doctor about the best plan for you. Some tears may heal on their own. Other tears may need to be repaired with stitches.

Prevention

You or your partner can start to massage the perineum with fingers and a lubricating jelly when you are about 34 weeks pregnant. After that, it should be done each day. This will soften the skin and may help it stretch during labor.

Care will be taken during birth to prevent a tear if possible.

RESOURCES:

The American Congress of Obstetricians and Gynecologists
http://www.acog.org
Women's Health—US Department of Health and Human Services
http://www.womenshealth.gov

CANADIAN RESOURCES:

Women's Health Matters
http://www.womenshealthmatters.ca

References:

National Institute for Health and Clinical Excellence (NICE). Guideline on intrapartum care of healthy women and their babies during childbirth. NICE 2014 Dec:CG190.
Perineal massage in pregnancy. American College of Nurse-Midwives website. Available at:
...(Click grey area to select URL)
Published January/February 2005. Accessed July 1, 2019.
Perineal trauma and repair in labor and delivery. EBSCO DynaMed website. Available at: https://www.dyname.... Updated May 24, 2019. Accessed July 1, 2019.
Last reviewed June 2019 by EBSCO Medical Review BoardBeverly Siegal, MD, FACOG
Last Updated: 10/2/2019

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