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Childbirth

Share experiences and get support around labour, birth and recovery.

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Original poster

A (possibly stupid) question about tearing I almost don't want to ask

59 replies

squishy · 03/09/2006 11:34

I've heard and read about a lot of people talking about 1st, 2nd, 3rd and 4th degree tearing and wonder if anyone could tell me what the differences are? Is it "just" extent of tearing? Sorry, horrible question, just feel very ignorant.

OP posts:

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Gobbledigook · 03/09/2006 11:37

Yes it's extent of tearing. I can't remember the definitions though.

JoolsToo · 03/09/2006 11:38

strange question - I have no idea, I ended up with episiotmies every time!

jabberwocky · 03/09/2006 11:49

I don't know the exact definitions, but there are some threads around here where people discuss 4th degree tears along with extensive reconstruction and having to wear a colostomy bag

motherinferior · 03/09/2006 11:57

It's, er, how far the tear goes down. I had a third-degree tear with DD2 which went - sorry about this - into muscle (episiotomy with DD1).

It healed, btw, perfectly OK.

juuule · 03/09/2006 12:13

Look here for more info on tears.
I had a 3rd degree tear with my 1st. It healed well and not really had any problems with it.

hollyhobbie · 03/09/2006 12:24

I've been wondering this too. I had 2 stitches, but I don't know if that makes it 1st or 2nd degree...
I couldn't make juuule's link work, but here's another one.

Original poster

squishy · 03/09/2006 12:28

That's brill, thanks! Rather alarming (!) diagrame in Juuules' link and this in hollyhobie's:
Perineal tears are classified into 4 degrees

1st degree tears are where the fourchette and vaginal mucosa are damaged and the underlying muscles exposed but not torn
2nd degree tears are to the posterior vaginal walls and perennial muscles, but the anal sphincter is intact
3rd degree tears extend to the anal sphincter that is torn but the rectal mucosa intact
4th degree tears are where the anal canal is opened, and the tear may spread to the rectum

OP posts:

jabberwocky · 03/09/2006 12:30

There is some evidence that tears can actually be worse with an episiotomy than without, although I'm sure it varies on the individual situation. I had a c-section with ds, so pretty much moot point with me.

Charleesunnysunsun · 03/09/2006 12:34

I had a 3rd degree tear boardering on 4th degree, it healed quite well although i do have a raised scar where it happened

sarahlou1uk · 03/09/2006 15:26

I had a 2nd degree tear with my second 2 weeks ago but it has healed naturally no probs.

katyjo · 03/09/2006 16:23

Hi Squishy, Are you expecting? I was absolutely terrified of tearing before I had my ds (now 5 months), I was more scared of this than any other part of labour, but I have to tell you I had to ask the midwife if I had torn(I had a 2nd degree tear) I didn't have any problem sitting and although I was slightly uncomfortable for a few days I felt alot better than I expected to (even without tearing). Don't spend too much time worrying about it, you will be fine!! And you are certainly not ignorant!

PinkTulips · 03/09/2006 16:35

if you have good midwives the'll control the head crowning by making you stop and pant or push on their instruction while they do their stuff down below.

i had a mw and a student mw with their heads between my legs and all four of their hands doing god knows what (you'd have to ask dp as he was the one wih the view!) while the mw told me when it was safe to push and when to pant as the skin was in danger of tearing. gave birth to 8ld10oz ds with his hand up next to his head without any tearing at all

relax, even if you do have some tearing it's all worth it when you have that little bundle in your arms!

Distracted · 03/09/2006 16:37

Hi Squishy - I was pretty scared about this too (or having an episiotomy) and I did have 2nd degree tears with both of mine. Ok first time I'd had an epidural so I didn't feel it (and carried on pushing when told to stop, which might be why I tore), 2nd time though was just on gas and air and can tell you that, like Katyjo, I had to ask the midwife if I had torn. So hope that's reassuring that actually there isn't any horrific sensation of tearing when it happens.

As for afterwards, I think the bruising is often the most painful thing when it comes to sitting down. First time round I had no bruising and there were other women on the ward with no tearing and obviously in more pain than me due to bruising, so tears don't have to be a big deal.

Original poster

squishy · 03/09/2006 18:31

Thanks again, yes, I've got about 8 weeks to go and it's one of the things that's been on my mind a lot. I'm hoping for a home water birth, so wonder if the MW not being able to see/guide will be countered by the benefits of the water. Also planning to start massage in a couple of weeks!! Thanks for the support and reassurance!!

OP posts:

morningpaper · 03/09/2006 18:54

Squishy: I have had the pleasure of a 2nd degree and 3rd degree tear.

The problem with tearing with a waterbirth is not so much the tearing per se, but how you want it dealt with afterwards. If you haven't had any pain relief, then you might want to think about how or whether you want stitching done.

Personally I had a third-degree tear with stitching (after an epidural) and I could feel the stitching but it wasn't too bad. A day afterwards it felt absolutely FINE. I had a second degree tear with NO stitching (waterbirth) and I was in A LOT of pain for weeks afterwards. I would NOT recommend this and would definitely get it stitched next time with a HEAVY AMOUNT OF local anesthetic.

Some midwives do not like to stitch second degree tears so it is well worth preparing yourself with a plan beforehand.

All the best!

motherinferior · 03/09/2006 18:59

Yep; my tear was with a home birth in water, and midwives who were fab. They stitched it. I'm very glad they did.

MuddyMum · 03/09/2006 19:59

I also had a water birth. I did tear quite low down and needed stitches. It sounds awful and I was really worried about how it would feel but I would probably describe it as a scratching / pressure and certainly not painful. The stitches were more of a nuisance when healing as they caught on my underwear and rubbed a bit. So I had them removed asap when healed.

Frizbe · 03/09/2006 20:17

Get rubbing the olive oil in down there is what I highly recommend I'm sure its saved my nether regions from any tears (sorry to the rest of you

samnbabes · 03/09/2006 20:34

ooh, I was more scared of tearing than ANYTHING else in the whole childbirth thing - tore (2nd degree) both times, and just to put it into perspective, squishy, didn't realise either time - in fact, with second birth, I was confident I hadn't, and asked the m/w if she was sure... And with ds1, I was actually giggling as they stitched me up (never thought I'd write that) - that's how fabulous gas & air is....!! Good luck, and try not to worry too much - it ain't as bad as you're thinking.

UselessMum · 03/09/2006 20:53

agree! tearing was what scared me as well. I was ok about everything else. So scared I was that when I could feel dd's head pushing right there I honestly considered the option of leaving her there. I did tear but did not feel it at all. Don't know what degree as they did not say, but she stiched for a while. And as for the stitching, the pain was so small I would not even call it that. After that I was a bit unconfortable and scared of having a poo, that's about it.
6 hours after dd was born I was home and the next day I walked all the way to tesco with shopping and that (I needed to be alone for a minute!).

Glassofwine · 03/09/2006 20:58

I was worried about tearing too. My first baby was 8lb 13oz - so not small and I had a small tear, which didn't need stitching. The following two babies were more or less the same size and I never needed stitches. I put it down to the midwife carefully guiding me at the point that the head was about to come out and also she placed a warmed (sterile) flannel to the area, which she claimed helped. I consider myself to be very fortunate. Talk to your midwife.

1Baby1Bump · 03/09/2006 21:10

ds was 9lb9.5 and i had a waterbirth in hospital. i got out and onto bed and was told i had 2nd degree tear which would need stitching as it was bleeding. i insisted it would be fine (needle phobic) but mw said it needed stitching. she sprayed some stuff on my bits to numb them while i lugged the g&a then put some injections in at each graze/tear. i kept on glugging and didnt feel a thing. in fact i remember having a laugh with her about my sex life being in her hands and even asked to look at it in a mirror afterwards! tearing was my worst fear but i didnt feel it happen and didnt feel it being repaired. a bit sore afterwards and it felt a bit strange during sex for a few months but couldnt have been that bad as ds2 was conceived when ds1 was only 4 months old!!

morningpaper · 03/09/2006 21:27

ohyes don't worry about FEELING the tearing

your body is feeling so many other things at that time that you certainly won't think "Aha! there goes my perineum"

aaronsmummy · 03/09/2006 21:32

I had a 4th degree tear, i am scarred but then it's not a pretty area anyway. No problems with healing at all, was too engrossed with my beautiful baby to notice.

bumpmakestwo · 03/09/2006 21:38

Oh Katyjo, me exactly the same, although I had a girl. Squishy - She is 5mths now, I had 2nd degree tear and it was the one think I was terrifed about. I only had gas and air and was so worried about it, I wasn't pushing...hence why in the end i probably tore!! But honestly whilst I could feel a kind of tugging, there was no pain as the contractions were where my concentration was at. As for stitching afterwards, again no problem, doc was lovely and I had my baby sucking on my breast so nothing else mattered!

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