Vaginal lacerations are tears in the vagina or in the skin and muscle around the vaginal opening. Tears most commonly occur in the perineum. The perineum is the area between the anus and the opening of the vagina.
There are 4 degrees of vaginal laceration:
The deeper vaginal lacerations may occur during vaginal delivery. Examples of causes include:
Minor lacerations can occur during sexual intercourse.
Factors that may increase your risk of a vaginal laceration include:
Your doctor will be with you during labor and will see any tearing if it happens. The seriousness will be based on the size of the tears and what muscles are affected. If the doctor thinks you may tear during pushing, an episiotomy may be advised. This is a surgical incision of the perineum. An episiotomy will make the vaginal opening temporarily larger so that the baby does not tear the vagina or the surrounding muscles.
Talk with your doctor about the best treatment plan for you. Treatment options include:
First degree tears are superficial. They often do not require stitches and will heal naturally. Second degree tears are deeper into the tissue, require a few stitches, and heal well afterward. Third and fourth degree tears require more stitches to be repaired correctly.
Stitches to Repair Third Degree Tear
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To help reduce your chance of getting vaginal laceration, take the following steps:
The American Congress of Obstetricians and Gynecologists
Women's Health—US Department of Health and Human Services
Women's Health Matters
Clinical management guidelines for ostetrician: gynecologists. ACOG Practice Bulletin. 2000;17.
Leeman L, Sprearman M, Rogers R. Repair of obstetric perineal lacerations. Am Fam Physician. 2003;68(8):1585-1590.
Perineal massage in pregnancy. American College of Nurse-Midwives website. Available at:
http://www.midwife.org/ACNM/files/ccLibraryFiles/Filename/000000000656/Perineal%20Massage%20in%20Pregnancy.pdf. Published January/February 2005. Accessed March 29, 2016.
Perineal trauma and repair in labor and delivery. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated November 23, 2015. Accessed March 29, 2016.
Last reviewed March 2016 by Andrea Chisholm, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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