Facing your fears by understanding severe tears during childbirth.?

Childbirth is a beautiful and transformative experience, but for some, the thought of sustaining a severe tear during delivery can be frightening. The truth is that tears are a common occurrence in childbirth, but with the right preparation and management, they can be treated and heal effectively. In this post, we aim to dispel common misconceptions about severe tears, provide accurate information, and give tips for how midwives and obstetricians can help patients prepare for the possibility of tears during labor.?

What is a severe tear?

Firstly, let's define what a severe tear is. Tears or lacerations can occur in the perineum, the area between the vagina and the rectum. Mild tears occur in up to 80% of vaginal births. However, severe tears, also called third or fourth-degree tears, happen in around 2-9% of vaginal births. Third- and fourth-degree tears involve the perineal muscles and the muscles of the anal sphincter. These more severe tears are then categorized as 3a, 3b or 3c and 4th degree, depending on how much of the anal sphincter muscles are torn.?

There are several factors that can increase the likelihood of a severe tear, including prolonged second-stage labor, larger baby size, assisted delivery with forceps or ventouse/Kiwi, and previous perineal injury or surgery. Women who have previously experienced a third or fourth-degree tear are at higher risk of reoccurrence.??

Can you prepare for a tear?

Midwives and Obstetricians can take steps to prepare patients for the possibility of severe tears. It is essential to ensure women are informed about what perineal trauma is. It is also crucial to discuss perineal massage and techniques which can be used to reduce the risk of tearing.???

Perineal massage, which can be performed by the patient or a partner, can help increase the flexibility and elasticity of the perineum and reduce the need for episiotomy, a surgical cut made to help prevent tearing. Giving birth in an upright position, such as squatting, also helps to increase the diameter of the pelvic outlet, improving the chances of a natural birth without assisted delivery, consequently reducing the chance of tearing.??

What happens if a tear occurs?

If a tear does occur, pain management is essential, including local anesthetic will be used for suturing. Pain-relieving medication can help with initial discomfort post suturing. Midwives and obstetricians will also examine the extent of the tear and determine whether stitching is necessary. Stitches help to bring the muscles back together, allowing for proper healing. It is essential that the doctor or midwife has all the necessary tools to be able to classify and repair the damaged layers of muscle and skin to the highest standard.??

While severe tears can be frightening, with the proper preparation and treatment, they can be effectively managed. By discussing the possibility of tears and providing information on prevention and treatment, midwives and obstetricians can help women feel empowered during this important time.?

In summary, childbirth can be an overwhelming but beautiful experience. Midwives and obstetricians are there to prepare patients for all possible outcomes, including severe tears. By having open conversations about the possibility of tears, discussing prevention techniques such as perineal massage, and providing information on treatment options they can empower women and reduce anxiety around this topic. There is no better feeling for healthcare professionals than when you have an open and honest conversation which leaves a woman empowered by their new knowledge.?

Don't forget to share this newsletter with others who might find it helpful. Until next time, keep pushing, stay strong, and remember - you're doing an incredible job. See you in our next edition!

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No material in this newsletter is intended to be a substitute for?personalised?medical advice,?diagnosis or treatment.?By providing the information contained herein we are not diagnosing, treating, curing, mitigating or preventing any type of disease or medical condition.?

Always seek the advice from your registered health care professional if you have any questions regarding any medical concerns or conditions.?Do not disregard personalised professional medical?advice or delay in seeking it because of something you have read in this newsletter.?