Most people who give birth vaginally damage the vagina and perineum during childbirth through tears. Here, we go through the different degrees of tear and how quickly you will recover.

During a birth, the midwife assists you so that you have the smallest tears as possible. Birth-related tears are common, and the vast majority of women who give birth experience some form of tears. These are divided into four grades:

• Grade 1: Includes superficial tears in the vagina and/or labia
• Grade 2: Engages muscles in the perineum
• Grade 3: Involves the rectal muscle, in whole or in part
• Grade 4: Also engages the wall of the rectal canal

Larger tears (grade 3 & 4) are unusual and occur in just under three percent of all births. The figure is slightly higher, about five percent, if it is the first time you give birth.

Grade 1 and 2 tears can be sutured by the midwife in the delivery room and you have the right to receive anaesthesia beforehand. Grade 3 and 4 sutures are performed by doctors, usually in surgery where the right lighting and tools are used for the best results.

The risk of getting a larger tear is higher if you give birth using a ventouse, are circumcised or you give birth to a large baby (over 4.5 kg). Smaller tears often heal quickly and wounds in the skin/mucous membrane heal within a couple of weeks. Some feel their tears more and for longer than others.

After a vaginal birth, the muscles in the pelvic floor are stretched to approximately three times their length, and the pelvic floor is also exposed to enormous stress through pregnancy. It often takes several months for the muscles to heal completely, so it is important to rebuild the pelvic floor using squat exercises. If you need help, you can contact a physiotherapist.

You can expect it to take up to a year before the pelvic floor is fully restored after childbirth. That being said, there is no reason to leave any concern or pain unaddressed. If you have questions or concerns about your tears, you can get help from, for example, your midwifery clinic, gynaecologist or the maternity clinic where you gave birth.

Tip!

Look at your abdomen before giving birth to get a reference image. Then look after childbirth and/or after you have been sutured. Often a tear may feel larger than it is/was. If you look with a mirror, you can also follow the healing process at home!