Feeling, seeing and bleeding
Tearing, what are the chances?
What is an episiotomy?
History of episiotomy
Midline vs. mediolateral episiotomy
Will I need an episiotomy?
How can I avoid an episiotomy?
Do I need to be shaved?
Care after birth
Episiotomy and tearing in Australia
The perineum is the tissue that lies below the vaginal opening and above the anus. During a vaginal birth it is the most likely part of the woman's genitals to tear, although not the only possible place. If the perineum does tear, the type and extent of the tear is categorised by the caregiver and recorded on the woman's medical records. Tears to the genital area are graded as follows:
Intact
Grazes
1st degree tear
2nd degree tear
3rd and 4th degree tears
Vaginal wall tears
Cervical tears
Other tears
Intact
refers to no obvious injury to the genital area. The genitals are still tender and sore with a raw feeling for a while, but there is no injury requiring stitches.
Grazes
of the vagina, perineum or the inside of the labia (the lips of the vagina) are splits in the skin or result when the top layer of skin is removed (similar to when you graze your knee). These types of injuries rarely need stitches. Sometimes labial grazes are stitched if the caregiver or woman feel that leaving them exposed will be too painful for a long period (more than a few days), as labial grazes often sting when the woman passes urine. It is possible to take a urinary alkaliniser, a powder available over the counter that fizzes when added to water and makes the urine less acidic, therefore not stinging as much. Alternatively you can pass urine while in the shower or bath or pour a warm jug of water over your genitals as you pass urine to reduce stinging.
1st degree tear.