Episiotomy or Tear at Birth – What You Need to Know!

Cases of episiotomy and tear are becoming very common and you may just be among many moms who had episiotomy or tear when giving birth. It is, therefore, only appropriate that you know about the two for proper care and management. Episiotomy and tear are two different things and it is only necessary that you know what happens during birth so as to able to understand how the two differ.

The birth canal naturally stretches during birth. It is the stretching that makes it possible for your infant to pass through. The actual part that stretches is the perineum, which is the skin that separates the vagina and anus. Episiotomy occurs when the skin cannot stretch enough to allow your infant to pass through and a midwife has no other option but to cut the perineum to make the opening wider. On the other hand, a tear occurs when your infant forces the perineum to stretch and tear on its own. Of the two, the tear is more common than the episiotomy.


There are two types of episiotomy: midline and mediolateral episiotomy. Midline episiotomy refers to a cut that a midwife makes from the vagina directly to the anus. Mediolateral episiotomy refers to a cut a midwife makes indirectly to the anus.

You may have undergone episiotomy in a case where your infant’s heart rate was low to appoint where he/she was distressed, in case the infant was coming out with another part of the body first instead of the head, if you had prolonged labor, if your infant was big or in case you have a medical condition that made it necessary to have a speedy labor for your own safety. Whichever the case, a midwife must have stitched the resultant cut with dissolvable stitches.


As has already been indicated, it is your infant who caused you a tear, in which case you probably sustained any of the following degrees of tear;

  • 1st-degree tear – This is the minor tear you may have suffered. It is a small tear that occurs when an infant is passing through and does not require any stitching. It eventually heals on its own.
  • 2nd-degree tear – This is a tear often caused by big infants. It occurs when the hind part of the vagina and the perineum get torn. The resultant tear(s) need to be stitched in order to re-attach to heal.
  • 3rd-degree tear – This is a high degree of tear you most probably suffered while giving birth. It is associated with tearing of the perineum/surrounding muscles and the area behind the vagina getting torn. Another tear can occur to extend to the anal sphincter. The resultant tears must have been stitched to heal.
  • 4th-degree tear – This is the worst tear you may have suffered. It is similar to the 3rd degree tear except that it extends to the rectum.


Recovering from an episiotomy or tear can take a short or long time depending on the degree of damage. Minor episiotomy and tears can take as short as two weeks to heal while serious episiotomy and tears can take up to a month or slightly more to heal. Whichever the case, you may end up with a scar.

Episiotomy and tears can be painful and because for discomfort until you recover. Luckily, you can prevent them by massaging the perineum on a regular basis several weeks before you give birth. You can do this by using vegetable-based massage oil. You only need to insert your fingers into the vagina before pressing down in the direction of the anus, stretching the perineum and holding the stretch for several minutes before releasing.

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