A vaginal tear (perineal laceration) is an injury to the tissue around your vagina and anus that can happen during childbirth. There are four grades of tears, with a fourth-degree tear being the most severe. Several at-home remedies can treat vaginal tears.
A vaginal tear happens during childbirth. Also called a perineal laceration, this is a tear in the tissue (skin and muscle) around your vagina and perineum. The perineum is the space between your vaginal opening and your anus (butthole).
During a vaginal delivery, the skin of your vagina prepares for childbirth by thinning out. This part of your body is meant to stretch and allow your baby’s head and body to pass through without trauma. But it’s very common for your vagina to tear. Up to 90% of people who give birth will have some tearing during a vaginal delivery.
Treatment for vaginal tears depends on the severity of the tear. There are several at-home treatments you can to do reduce your discomfort.
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There are four different grades of vaginal tears. The severity of the tear determines the grade.
A second-degree tear is the most common. It involves the first layer of your perineal skin and some of your perineal muscle. Only about 5% of people have third- or fourth-degree tears.
A vaginal tear during childbirth happens because your baby stretches your vagina and perineum during birth. This is normal and common. Some factors, like your vagina’s ability to stretch, are beyond your control. Factors like your baby’s size or situations that arise during delivery may put you at higher risk for vaginal tearing.
Some factors increase your chances of tearing. These include:
Talk to your pregnancy care provider to determine if you have any risk factors for vaginal tearing.
Vaginal tears can be uncomfortable and painful, but most small vaginal tears heal within two weeks. It’s common to feel discomfort for a month or two if your tear was larger. Third- and fourth-degree tears come with more complications due to the severity of the injury.
Some of the most common complications of vaginal tears include:
If you experience any of these complications, let your provider know at your postpartum appointment. They can let you know if what you’re experiencing is normal.
Everyone’s birth experience is different, so there isn’t a clear answer. If you had an epidural or other pain relievers during delivery, you’ll likely have no clue if or how much you tore until your provider tells you. However, even if you deliver with no pain medication, you may not feel a vaginal tear.
Treatment of a vaginal tear depends on the severity of the injury. In a first-degree tear, you probably won’t need stitches. In a second-, third- or fourth-degree tear, you’ll receive stitches to repair the tear. Any stitches will dissolve on their own within six weeks. Providers treat most tears right in the delivery room. However, larger tears may require transfer to an operating room where the lighting is better and the surgeon has access to different equipment. This is especially the case if there’s a lot of bleeding.
In some of the most severe cases, your healthcare provider may need to repair the injury to your anal sphincter. This treatment also uses dissolvable stitches.
You may feel some discomfort in the weeks after delivery while your tear heals. There are a few things you can do to help ease this discomfort. These tips work with each type of tear:
Make sure you check with your healthcare provider before taking any pain relief medications. What medicines you can and can’t have may change if you’re breastfeeding (chestfeeding).
Most people feel relief from any pain caused by a vaginal tear in about two weeks. If your tear was larger, it may take longer. Your stitches dissolve on their own and you don’t need any additional treatment for the tear. Keep an eye out for any signs of an infection while your tear heals. These can include:
Some people experience pain with sex after having a tear. If you feel any pain or discomfort with sex, talk to your provider. There are treatments to help with this.
Most vaginal tears are unavoidable. But there are some things you can do to try to prevent tearing:
Remember, these methods may help reduce tears, but most studies show only a small reduction in the amount of tears. It’s best if you talk to your pregnancy care provider about these and other methods to prevent tearing.
Yes, it’s possible to give birth without tearing. But most people tear at least a little.
An episiotomy is a procedure where your healthcare provider makes a cut from the edge of your vaginal opening outwards. This widens your vaginal opening in a controlled way, but it doesn’t always keep you from tearing. Healthcare providers don’t recommend routine episiotomies and prefer that you tear naturally. The latest research suggests it’s better to let your perineum tear naturally.
Yes. You can still plan for a vaginal delivery if you’ve torn in a previous delivery. Even in studies of people with severe tears, there’s no clear evidence that says you should avoid a vaginal delivery in the future. The exception to this may be if you have bowel control issues or distress from a previous vaginal tear. If you’re unsure about a future vaginal birth, talk to your pregnancy care provider.
Not necessarily. Tearing the first time you give birth doesn’t mean you’ll tear in subsequent deliveries. In fact, most people find they tear less with each delivery. In most studies, the chance of having another third- or fourth-degree tear is less than 3%. It’s always best to discuss your concerns about tearing with your pregnancy care provider.
You should contact your pregnancy care provider when:
A note from Cleveland Clinic
Vaginal tears during childbirth are a common concern for many pregnant people. Talk to your healthcare provider before delivery and express your concerns about tearing. They can talk to you about your risk of tearing and offer some guidance. Most people don’t experience severe tears and heal within a few weeks of childbirth. Larger tears require stitches and take longer to heal. Luckily, there are several at-home remedies to make your perineal area feel better as you recover. Contact a healthcare provider if you experience any long-term complications of a vaginal tear like pain during sex.
Last reviewed by a Cleveland Clinic medical professional on 07/24/2023.
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