Definition

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.

Causes

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.

Risk Factors

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

Symptoms

Vaginal tears cause pain and bleeding.

Diagnosis

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.

Treatment

Some tears may heal on their own. Other tears may need to be repaired with stitches.

Prevention

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.