Postpartum Recovery From a Third-Degree Vaginal Tear
Will I Ever Heal?
That's the question I kept asking myself postpartum. The answer, I now know, is yes. It just happens in its own time—a lot of time for some, myself included.
Tearing during delivery was one of the things I was most afraid of before having my baby. A vaginal tear just has a traumatic sound to it. No one wants to tear anything, but especially not that. I spent a good bit of research looking into how to prevent a vaginal tear during delivery (it was all pretty inconclusive). But I never prepared myself for the postpartum recovery process.
"Bet you feel like I'm knitting a sweater down here."— My delivery room doctor
Day 1: Freshly Torn
I had my first baby on October 16th, around six in the morning, after thirty-five odd hours of labor. It was finally over. I had my baby on my chest, still all covered in goo. My husband had cut her cord, we had pushed my hospital gown to the side so that she was skin to skin and one of the nurses gave us a towel to shield her eyes from the bright light of the doctor’s lamp. Yeah, the doctor was still there, crouched on his stool between my stirrup-ed legs. He was saying something about a third degree and calling for a retractor, all while stitching away.
I had been eager enough to ignore him up to that point, but it was getting harder.
“Third degree bad?” I asked.
“It’s not a fourth.” He said. He explained that there are four degrees, from first to fourth (forth being the worst), before saying, “Bet you feel like I’m knitting a sweater down here.” Not the most comforting statement, but he wasn't wrong.
Week 1: Recovery Begins
I spent the rest of my hospital stay feeling thoroughly broken. The nurses/doctors didn’t seem to care about the degree of tear. It was all the same to them, and I tried to take that as a good thing. They just kept checking the swelling and giving me ice packs. I was very swollen. I felt like I had an extra pair of butt cheeks between my legs and I didn't fit any of the underwear that I had packed. Before being released, I asked the nurse practitioner what the recovery time frame was.
“It takes about two weeks for the swelling to completely recede.” She reassured me. She advised me to continue taking stool softeners and using ice packs. Then it was time to go home.
Degree of Tear
Percentage of Women Affected
1st and 2nd
About two weeks
3rd and 4th
Six months or longer
Week 2: The Long Road Ahead
After two weeks, I found myself standing in the shower and considering those words. True, I no longer felt like a lumpy baboon, but I was still puffy and tender, and very concerned that I might be that I might look like that forever. So, I began searching the internet for answers.
The degrees of tears go like this:
- First degree: Minor tissue tear, may or may not require a few stitches.
- Second degree: Some muscle under the tissue tears, requires stitches and a few weeks of healing time.
- Third degree: This tear extends through tissue, muscle and into the anal sphincter. Usually takes six months, or more, of healing time.
- Fourth degree: The last degree extends all the way through the anal sphincter. Clearly takes longer to heal!
What Should I Do During the Recovery Process?
- “Do not get brave and look in a mirror down there.” Very helpful advice considering how unattractive I already felt.
- “Keep extra hydrated and eat plenty of fiber.” This is especially true if you are breastfeeding like I was. All your hydration just keeps shooting straight to your boobs.
- “Stop taking the prenatal pills." This could be different for everyone depending on your body's iron level. I had continued taking it, believing that I would help breast feeding, until a doctor asked if I was still struggling with constipation even on the stool softener. I clearly did not need all that iron.
- “Use lubricant for sex.” At the six-week check-up, the doctor advised lubricant for sex. Like I’m going to ever have sex again, right? But, eventually, I did.
- “Remember to do your Kegel exorcises.” I didn’t start doing these again until recently, but there is never a bad time for them. Muscle problems seem to creep up at a variety of time frames as you heal, from months to years later.
- “Sleep with ice packs between your legs.” My body would heat up while I slept, usually curled up on my side and when I woke up I would be all swollen again.
I found some more great advice on WebMD.
Month Six: Maybe I Healed Wrong
At the six-month mark, I was still sore and sex was extremely painful. I felt like maybe the doctor had sewed something wrong, or the muscles had healed wrong, or maybe there was a bunch of scare tissue getting in the way.
When I finally went in, the doctor reassured me that I looked perfectly normal. Tissue was stretching normal, but the muscles were very tight and would take time to relax and stretch. She told me that some of the pain I was describing was more than likely due to oversensitivity, caused by hormones from breastfeeding/post pregnancy. She wrote me a referral to see a physical therapist, but I decided that knowing things were normal down there was all I needed.
Ten Months Later: (Almost) All Healed!
Writing this, I’m still healing. My baby is ten months old at this point and we are still breastfeeding. Sex feels like sex again. It's still dry and oversensitive down there, but not it's painful. There is a tiny raised line of scar tissue that I can feel. Mostly, I know my muscles still haven't fully recovered, but that’s what Kegels are for. It sounds crazy, but I’m already thinking about baby number two.