Childbirth is a powerful experience, and it often brings natural stretching of the tissues around the vaginal area. In some cases, small tears occur as the baby is delivered. A first-degree perineal tear is the mildest form of vaginal tearing, affecting only the top layer of skin around the vaginal opening and the perineum (the area between the vagina and anus). These tears are very common, especially for first-time births, and typically heal quickly with minimal treatment.
First-degree tears usually happen due to natural stretching of the vaginal tissues during childbirth. Some contributing factors include:
First vaginal delivery
Fast or forceful delivery
Large baby or baby with a wide head circumference
Use of forceps or vacuum assistance
Not enough time for tissues to gradually stretch
Thin or less elastic skin in the perineal area
Tears are often unpredictable and can occur even with a slow and controlled delivery.
A first-degree tear may cause:
These tears do not typically cause severe pain or long-term issues.
After the baby is delivered, your healthcare provider will:
A first-degree tear only affects the skin and does not involve muscles, making it the least serious type.
Most first-degree tears heal naturally without stitches. Your provider may recommend:
Cold packs to reduce swelling and discomfort
Warm sitz baths to soothe the area and promote healing
Pain relief medications, like ibuprofen or acetaminophen
Keeping the area clean and dry to avoid infection
Pelvic rest (no sex or tampons) for several weeks
If the tear is slightly deeper, a few dissolvable stitches may be used to speed up healing and prevent further tearing.
First-degree perineal tears are a common and minor part of many vaginal births. Though they may cause temporary discomfort, they usually heal quickly with proper care and pose no long-term health risks. Talk to your provider about ways to support perineal health during labor, such as controlled pushing and perineal massage. Knowing what to expect helps reduce worry and supports a smoother postpartum recovery.
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