Repair of first- and second-degree tears, care of stitches and what to expect when healing
What is a first-degree tear?
These are small tears, or grazes, affecting only the skin.
They can occur around the labia, clitoris or inside the vagina.
These tears can be referred to as lacerations, superficial abrasions or actual tearing.
First-degree tears usually heal quickly and without treatment. They are very unlikely to cause long-term problems, but they can be very sore.
What is a second-degree tear?
These are tears affecting the muscle of the perineum and the skin. These usually require stitches.
The repair is normally done using local anesthetic in the room where you had your baby.
Second-degree tears are unlikely to cause long-term problems, but they can be very sore.
Caring for your stitches
Good hygiene is important if you have had a first- or second-degree tear. Use only water to 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 go to the toilet or change your sanitary pads.
This will reduce the risk of infection.
Diet and water
It is important to eat well and drink plenty of water to help avoid constipation.
You should drink at least 2 litres of water every day and eat a healthy balanced diet (for instance: fruit, vegetables, cereals, wholemeal bread and pasta).
Opening your bowels
If you have stitches, opening your bowels should not open them.
It can be helpful to put your feet on a footstool, to raise your knees above your hips while sitting on the toilet
Try to relax and rest your elbows on your knees. Do not strain as this weakens your pelvic floor. Bulge out your tummy by taking big abdominal breaths, which will help expel your stool without straining.
Most importantly, take your time and do not rush.
What should I expect when healing?
If you have stitches, they will eventually all dissolve. When you have contact with a healthcare professional, ask them to examine your stitches.
Pain and discomfort
After having any tear, it is normal to feel pain or soreness after giving birth, particularly when walking or sitting. 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.
If you have stitches, they can irritate as healing takes place, but this is normal.
Placing an ice pack wrapped in a towel on your perineum may help. Do not place ice directly onto your skin as this may cause damage.
Passing urine can cause stinging depending on where your tear is.
Pouring body temperature water over the area when urinating can help.
Your pelvic floor
It is important to do pelvic floor exercises as soon as you can after birth. This strengthens the muscles around the vagina and the anus and helps healing.
Read more about pelvic floor exercises
Will I have any follow-on appointments?
You will usually be offered an appointment with a healthcare professional 6 weeks after you have 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.
When should I contact a healthcare professional?
- If your stitches become painful.
- If your stitches become smelly.
- If your wound does not heal.
- If you have been diagnosed with a first- or second-degree tear, but you are having problems controlling your bowels, for instance you struggle to make it to the toilet or control wind.
- If you have any concerns.