Is it normal for the vagina to tear during childbirth? (Vaginal Tears) Let's talk about this!

As a mother-to-be, you may be a little scared or curious about childbirth. It's very normal. One of the things that many people ask and fear is whether the area around the vagina will tear when the baby is born. This is actually something that many mothers experience. But before you get scared about it, let's talk about it clearly and simply.

Simply put, what is a vaginal tear?

This is what we medically call a ``Perineal Laceration''. Simply put, during childbirth, when the baby comes out of the vagina, the skin and tissue around your vagina are torn. The area between your vaginal opening and your anus is called the ``Perineum''. The tear usually occurs in this area.

Imagine, as the baby is about to come out, the skin in your vagina starts to stretch incredibly thinly. Our bodies are designed to stretch this area well so that the baby can come out without any harm. However, sometimes this area can tear a little when the baby's head comes out. Don't worry, this is very common. In fact, about 90% of mothers who have a normal delivery experience some degree of tearing.

The treatment for this tear depends on its nature. In many cases, home remedies can help reduce discomfort and speed healing.

There are four main types of these Iriyams.

These symptoms are divided into four main levels depending on their severity. Let's see what they are.

Why does this happen? Who is at increased risk?

The main reason for this tear during childbirth is the stretching of the vagina and perineum as the baby comes out. This is a normal process. We can't control things like the elasticity of your vaginal skin. However, certain factors can increase the risk of this tear.

• If this is your first birth.
• If the baby is facing up instead of facing down when it comes out.
• If you have to use a ``Forceps`` or ``Vacuum`` device to remove the baby.
• If the baby is a little overweight (more than 8 pounds).
• If the second stage of labor, the pushing stage, takes a long time.
• If you were given an epidural for pain relief.
• Some studies have found that Asian women are at slightly higher risk.

You can talk to your doctor about this and find out if you have any of these risk factors.

What complications can this cause?

A tear can cause some discomfort and pain. However, most minor tears heal within about two weeks. If the tear is a little larger, it is normal to feel discomfort for a month or two. With third- and fourth-degree tears, the risk of complications is slightly higher.

• Infection:If the wound is not kept clean, it can become infected.
• Bleeding.
• Pain during sex: (after doctor's permission)
• Fecal incontinence: This can occur in severe cases.
• Ongoing pain and soreness.

If you're feeling anything like this, be sure to tell your doctor at your postpartum appointment. He or she can then tell you if what you're feeling is normal or not.

How to care for a wound at home until it heals?

After having a baby, you will likely experience some discomfort while the tear heals. There are a few simple things you can do at home to help reduce that discomfort. These can be done for any level of tear.

• Take care of cleanliness: After using the toilet, use a `(peri-bottle)` (a squirt bottle) to rinse the area with lukewarm water. Instead of wiping with toilet paper, gently pat the area dry.
• Apply an ice pack: There are special sanitary pads that contain an ice pack that you can buy from pharmacies. Or, wrap a few ice cubes in a clean cloth and place them on the wound for 10-15 minutes. This will reduce swelling and pain.
• Prevent constipation: Avoid straining during this time. Drink plenty of water. Also, eat foods high in fiber (fruits, vegetables, and greens). If necessary, ask your doctor about taking a stool softener.
• Take a Sitz Bath: If you have a bathtub, fill it a few inches high with lukewarm water and sit in it for 10-15 minutes. This will reduce pain and help the wound heal faster. It's best to do this two or three times a day.
• Use a Donut Pillow: If you feel pressure on your wound when sitting, sit on a donut-shaped cushion with a hole in the middle. This will reduce the pressure on the wound.
• Avoid uncomfortable positions: Stop doing exercises that hurt the injury, such as going down stairs, squats, etc. for a while.
• Painkillers: Take a painkiller like paracetamol as directed by your doctor. If the tear is severe, he may prescribe a stronger painkiller.
• Painkiller spray: You can use a spray that reduces pain and numbness, such as ``(Dermoplast®)``, which can be purchased at pharmacies. However, it is wise to ask your doctor.

How long does it take to recover? What are the risk factors?

For most mothers, the pain and discomfort will be significantly reduced after about two weeks. If the tear is large, it may take longer to heal. The stitches you receive will dissolve on their own after a while, so there is no need to have them cut.

However, you should be aware of signs of infection while the wound is healing.

Can you think about having another baby?

Yes, it is definitely possible. Having a ruptured uterus in a previous birth does not mean you cannot have a normal birth the next time. Even studies that have used mothers who have had severe ruptured uterus do not provide clear evidence that a Caesarean section is necessary the next time.

Also, just because it tears the first time doesn't mean it will tear every time. In fact, most mothers experience less tearing during their second or third birth. So don't worry about it. Talk to your doctor about anything that's on your mind.

Episiotomy or episiotomy - which is better?

Sometimes, if the baby is not coming out fast enough, the doctor will make a small cut at the edge of the vaginal opening. This is called an ``Episiotomy''. This is done to enlarge the vaginal opening in a controlled manner and prevent uncontrolled tearing.

However, current medical opinion is that it is not recommended to routinely perform an episiotomy. The latest research suggests that it is better to let the tear heal naturally. Therefore, doctors are now rarely performing this incision, except in cases of extreme necessity.