Vaginal tear during childbirth - can it be prevented?
definition
A vaginal tear is an injury to the vagina, which is usually caused by a traumatic birth. It can appear in any part of the vagina. If the tear occurs at the point of attachment to the cervix, this is called colporrhexis. The labia can also tear, which is known as a tear in the labia. The dam can also tear.
A normal vaginal tear usually occurs in the side or back of the vagina. A vaginal tear is associated with bleeding and possible pain. Depending on the depth of the tear, it should be sewn or it will heal by itself. Mechanical stress can cause itching, burning and pain.
When does a vaginal tear occur?
A vaginal tear usually occurs during a natural birth. At birth, the vagina is exposed to enormous mechanical stress. As the child is pressed through the birth canal, all structures involved have to stretch a lot. If a point is stretched too much, it can tear. Usually the cracks appear on the vagina or the perineum. The labia can also tear under great pressure.
Risk factors include very tall or incorrectly lying children, which is often associated with the use of aids such as a suction cup or forceps. In these cases, the vagina is usually stretched to the maximum, which is not enough for the child to be born. The risk of a vaginal tear is also increased if a vaginal tear has already taken place in previous births or a perineal incision was performed. The scar tissue created at these points is no longer so robust against mechanical stress.
In addition to a ruptured vagina, perineal rupture can also occur during childbirth. Read more about this at: Perineal tear - how does it happen and how can it be prevented?
How can you prevent a vaginal tear?
There is no surefire way to prevent a ruptured vagina or perineum. Nevertheless, there are ways to strengthen the resilience of the tissue before and during the birth.
One possibility is the perineal massage. This should be carried out daily about the last six weeks before the due date. On the one hand, the vaginal and perineal region can be stretched in advance, on the other hand, you get to know the special feeling of pressure and stretching before the birth and can therefore relax better during the birth.
Another possibility to prepare the muscles for the birth is the pelvic floor exercises. The targeted tension and relaxation of the muscles can be practiced. It is important to relax and relax your muscles during childbirth. A controlled birth with slow development of the child enables the body to get used to the pressure and to stretch in a controlled manner.
To relieve pressure on the perineum, it may be helpful to crouch or quadruped to give birth. In addition, warm water, in the form of warm, wet compresses or in the bathtub, helps to make the fabric more elastic. If tearing cannot be avoided, a perineal incision is often performed. This prevents uncontrolled tearing and thereby lowers the complication rate.
One way to prevent a vaginal tear is to prepare optimally for the birth. We therefore recommend our pages to:
- Birth preparation course
- Courses for pregnant women
- Pelvic floor exercises during pregnancy
- Physiotherapy during pregnancy
Sometimes a rupture of the vagina cannot be avoided. In order to control the extent of the tear and to avoid complications, a perineal incision is then often performed by the doctor himself. Read more about this at: Perineal incision at birth
Treatment of the tear in the vagina
If the examination reveals a tear in the vagina, it is usually sutured. Only longitudinal cracks can be treated conservatively. The wounds are usually stitched up with a local anesthetic injection. Since the vagina is often a little numb after the birth, it can be sewn without anesthesia if desired.
If there are bruises (hematomas), these must be removed so as not to impair wound healing. The threads are self-dissolving, which is why they do not have to be pulled.
If the vagina is rarely torn from the uterus, also known as colporrhexis, a small operation must be performed under general anesthesia. To support the healing process, disinfecting hip baths or quark compresses can be helpful. Care should also be taken to keep the area clean and dry. It can be helpful to carefully clean the wound with clean water after using the toilet.
Also read the article: How does the vagina change after giving birth?
Accompanying symptoms of a vaginal tear
The symptoms of a ruptured vagina are very unspecific. On the one hand, there is persistent bleeding, which, however, can also originate from the uterus. On the other hand, pain can occur in the area of the tear. The tear in the labia in particular can be very painful, as there are a particularly large number of nails there. Often, however, these are not even noticed through the experience of the birth, but only afterwards. In addition to the pain, there may also be a burning sensation or itching, similar to a cut.
Pain
The vagina tearing is usually not noticed during childbirth. Even shortly after birth, a crack is often not noticed. A vaginal tear is usually sewn with a local anesthetic anyway. During the healing process, a wound can cause slight pain, especially if it is subjected to mechanical stress. This can be the case, for example, when you are seated, with your legs apart or tight trousers.
You might also be interested in: Pain in childbirth
itching
The wound may be itchy as it heals. A slight itch is usually not a cause for concern. However, depending on where the wound is located, the itching can cause additional pain, for example when walking and rubbing. In addition, the vaginal flow and urine can never keep the wound 100 percent clean, which can make itching worse. If the wound starts to become infected, it can also be noticed by itching.
Scarring
A tear in the vagina usually heals with a scar. During the wound healing process, the injured tissue is replaced by a new, very fiber-rich tissue. This also no longer has the same properties as the original fabric. For example, there are no longer any sweat glands or hair roots in it. Due to the nature of a scar, it can itch, tighten or pain. A slight restriction in movement is also possible.
What is a high vaginal tear?
In most cases, the vaginal tear occurs in the side or back of the vagina. However, if the vagina tears in the upper part of the vaginal vault, this is called a high vaginal tear. This can bleed profusely due to its proximity to the cervix.
Complications from a ruptured vagina
A possible complication of a ruptured vagina is the formation of a bruise (hematoma). This causes blood to accumulate in the tissues, which can lead to swelling and pain. In addition, this can disrupt wound healing, which is why hematomas are usually cleared out. In addition, the wound may become infected as it heals. In addition, the seam can tear again if subjected to too much tension. If severe pain or bleeding occurs during the healing process, a doctor should therefore be consulted.
A mucosal injury usually heals with scarring. During this process, what is known as scar hypertrophy can occur. This leads to excessive growth of the scar tissue. The thickened scar is visible and palpable and can lead to restricted mobility.
Learn more about the complications of childbirth: Childbirth complications
Inflamed vaginal tear
As a rule, a ruptured vagina heals without any problems. The sterile suturing of the wound makes it difficult for germs to enter. The body's immune system also helps to avoid infection. Despite all this, the wound is exposed to a constant supply of germs through the vaginal secretions and the urine. Therefore, it is very difficult to keep them clean. If the wound becomes infected, it may cause pain, itching, swelling, and redness. If this is noticed, a doctor should be consulted immediately. If a collection of pus (abscess) has formed, the wound must be opened. In the case of bacterial colonization, an antibiotic is also prescribed.
Duration of healing
Wound healing takes place in several stages. A scab forms in the first few hours to roughly close the wound. In addition, wound secretions are formed, which germs should wash out of the wound. The tissue defect is then gradually replaced with new tissue. This process takes about eight days. The final skin layers are then built up or the scar tissue is formed.
Diagnosis of a ruptured vagina
After the birth, the gynecologist will perform a vaginal examination. He pays special attention to birth injuries, such as blood accumulations (hematomas) or wounds. An abnormally long period of bleeding may indicate an injury. Pain or burning in individual areas also indicate a wound.
