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First and second degree tears

Repair of first and second degree tears, care of stitches and what to expect when healing

They are very unlikely to cause long-term problems, but they can be very sore.

First degree

These are small tears affecting only the skin which usually heal quickly and without treatment.

Tiny lacerations can occur around the labia, clitoris or inside the vagina.

Tears to the labia or clitoris can be either superficial abrasions or actual tearing.

Second degree

These are tears affecting the muscle of the perineum and the skin. These usually require stitches.

 

Where do second degree tears occur?

 

Caring for your stitches

Hygiene

Keep the area clean.

Wash or shower at least once a day and change your sanitary pads regularly. Wash your hands both before and after you do so.

This will reduce the risk of infection.

Diet and water

You should drink at least 2 litres of water every day and eat a healthy balanced diet (fruit, vegetables, cereals, wholemeal bread and pasta).

This will help your bowels open regularly and help avoid constipation.

Opening your bowels

It may help to try some gentle pelvic floor exercises to help you remember how to relax to pass urine.

It can be helpful to put your feet on a footstool, to raise your knees above your hips while sitting on the toilet.

This can make it easier to open your bowels.

 

What to expect when healing

Stitches

If you have stitches, they will eventually all dissolve (soften and fall out).

Pain and discomfort

After having any tear, it is normal to feel pain or soreness for 2 to 3 weeks after giving birth, particularly when walking or sitting.

The stitches can irritate as healing takes place, but this is normal.

Passing urine can cause stinging depending on where your tear is.

Talk to a healthcare professional about pain relief if you think you need it.

How long will it take to heal?

The skin part of the wound usually heals within a few weeks of birth, and after that you should feel much less raw and tender.

When you have contact with a healthcare professional, ask them to examine your stitches.

If you find that your wound is still open or bleeding after that time, or if your wound becomes smelly or increasingly painful at any point, you should get a healthcare professional to look at it. If it is infected, you may need some antibiotics to help it heal.

When going to the toilet

Passing urine can cause stinging depending on where your tear is, but this should ease as your wound heals.

If you have been diagnosed with a first or second degree tear, but you are having accidents from your anus or you struggle to make it to the toilet or to control wind, you should tell a healthcare professional.

You may need to have your tear looked at again or be referred for a hospital appointment.

 

Appointments and support

You will usually be offered an appointment with a healthcare professional 6 weeks after you had your baby, to make sure that you are recovering well.

At that appointment, you will be able to discuss any concerns and ask any questions you may have about the birth of your baby and any of your symptoms or concerns about future pregnancies.

If you feel need to see someone sooner, get in touch with a healthcare professional (i.e. a GP, midwife, or health visitor).

 

Further information

Caring for yourself after childbirth

Including what you changes you can expect, and when to be concerned:
https://www.nhs.uk/conditions/­pregnancy-and-baby/you-after-birth/

Sex and contraception after childbirth

https://www.nhs.uk/conditions/­pregnancy-and-baby/sex-contraception-after-birth/

Caring for yourself after an episiotomy or tear after childbirth

https://www.nct.org.uk/parenting/­episiotomy-or-tear-during-childbirth

Changes to your vagina after childbirth

https://www.nhs.uk/live-well/sexual-health/vagina-changes-after-childbirth/

 

 

 

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A–Z of common medical words in women’s health
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