(Laceration, Vaginal; Vaginal Tears; Tears, Vaginal)
Vaginal lacerations are tears in the vagina or in the skin and muscle around its opening. Tears are most common in the space between the opening of the vagina and the rectum (perineum). The tear may be minor or very deep.
Deep tears may happen during vaginal delivery when:
- The baby's head is too large to fit through the vaginal opening
- Labor is very rapid
- Delivery is done using instruments
Minor tears may also happen during sex or from an injury to the crotch.
Birth factors that may raise the risk are:
- Having a very large baby
- Having a baby for the first time
- Having had tears with a prior pregnancy
- Delivery with instruments
- Baby's shoulder gets stuck
Other things that may raise the risk are:
- Putting an object in the vagina
- Thinning of the vagina
Vaginal tears cause pain and bleeding.
The doctor will see tearing that happens to a woman giving birth.
A woman who is not giving birth will be asked about her symptoms and health history. A physical exam will be done. This is often enough to make the diagnosis.
Some tears may heal on their own. Other tears may need to be repaired with stitches.
The risk of this problem may be lowered by massaging the perineum with fingers and a lubricating jelly starting at 34 weeks of pregnancy. This will soften the skin and may help it stretch during labor.
The American Congress of Obstetricians and Gynecologists
Women's Health—US Department of Health and Human Services
Women's Health Matters
Perineal massage during pregnancy. American Pregnancy website. Available at: https://americanpregnancy.org/healthy-pregnancy/labor-and-birth/perineal-massage-pregnancy. Accessed August 24, 2021.
Perineal trauma and repair in labor and delivery. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/perineal-trauma-and-repair-in-labor-and-delivery. Accessed August 24, 2021.
Last reviewed July 2021 by EBSCO Medical Review BoardBeverly Siegal, MD, FACOG Last Updated: 8/24/2021