Birth Tears and Stitches and Stigma, Oh My!

Truth: Birth tears are often only discussed somewhat like campfire horror stories. Most women do think about this when they think about having a baby, but it’s more of the “OMG, what if I rip” thought. What no one discusses is what actually happens if you tear and how to deal, physically and emotionally. According to Parents magazine (2020), there’s a 95% chance of tearing for first-time moms. This means that so many of us, like me, will be forced to do our own research and learn about tearing AFTER it has happened to us, and most likely all alone. If you keep reading, I will educate you on what I’ve learned about birth tears and my physical and emotional experience during my own healing process.

Facing The Facts

Tearing vs. Episiotomy: A tear happens on its own, and an episiotomy means your doctor made an incision to help the baby come out. The thought on episiotomies used to be that it is better to cut than tear because an even cut is easier to repair. However, the latest medical approach is to try to avoid episiotomies. As explained by my doctor, this is because when your baby is coming out and you tear, it means you tore in the most productive area that actually needed to expand to get your baby out. So, if your fear is having an episiotomy, please advocate for yourself. They can be unnecessary, not all that helpful, and not a procedure your doctor should be considering routine these days.

Not all tears are created equal: If you tore, that does NOT automatically mean you tore all the way through your behind. Tears are classified in four degrees, with first degree being the most minor and fourth degree being the most severe. The degree is based on how far the tear went and if any damage was caused to the anal sphincter. A first-degree tear may not require stitches, and a fourth-degree tear may require surgery and PT.

My tear: Personally, I endured second-degree tearing. While I am so “lucky” to have not torn through my butt, I actually experienced tearing downward AND upward, which I didn’t even know could happen before it happened to me. Yes, that means I had to heal from two different tears, and the effects were a lot longer lasting than I anticipated.

Physical Recovery

Ice and witch hazel pads will be your BEST friends! Also take the can of Dermaplast from the hospital if you can.

Your stitches might feel itchy when you start to heal. This was super annoying, but again, keep using your witch hazel pads. It gave relief to the itching for me.

Once you begin healing, your stitches may visibly fall out. I remember around 5 days after having Myles, I was using the bathroom and saw a strange little knotted loop on the paper. They say that they “dissolve,” but a lot of mine more like fell out. Since I don’t know how many I actually had, some of them could’ve dissolved. Don’t freak out like I did if you see some of them.

It is possible to heal then re-tear. At nearly 4 weeks postpartum, I started to do too much because I was feeling better. It definitely backfired because I ended up re-opening my upward tear. At my 6-week check-up, my doctor confirmed that, and he said to just give it some time. I didn’t require additional stitches, and it healed up for good around 8 weeks postpartum.

It might burn when you pee. Because I tore toward my urethra, peeing was pretty painful until a couple of months after giving birth. Even if it hurts, don’t let that discourage you from drinking enough water and using the bathroom. It would be much worse to also get a UTI!

You might feel “pulling.” Even after my tears had healed, I felt uncomfortable pulling sensations near the areas that had been repaired. It took about 4 months for that to fully go away.

Common postpartum complications can be exacerbated by tearing, especially if severe. Directly after having a baby, you may expect some level of urinary incontinence. If you tore, especially badly, you might also experience fecal incontinence, anal fissures, infections, or other awkward-to-discuss things. If you end up with lasting complications, you might want to see a specialist to figure out how to manage or heal them.

You might feel your scar, even after you’ve healed. Certain ways of sitting, exercises, sex positions, etc. can be uncomfortable on your scar tissue. Occasionally I do have pain in my scar and can pinpoint exactly where my tear was.

Emotional Recovery

Fear of the unknown – I was so freaked out immediately after giving birth and getting all fixed up that I didn’t even ask how many stitches I had or what degree my tear was. (Thanks campfire horror story birth tear culture!) No one EVER told me until a specialist asked me about it when trying to treat me for complications and I had to message my OB to find out 5 months after having Myles. I’d recommend having that conversation with your doctor so that you are clear on how to take care of yourself. I think knowing this would’ve prevented me from opening my tear back up by taking on too much too soon.

Feeling like you are “ruined” – People put a lot of pressure on women to be perfect, right down to the tightness of the vagina. You are not ruined or gross if you tear. You will not be “loose.” You might feel like there’s a stigma or it’s a dirty little secret, but so many moms know exactly how you feel and have healed from similar experiences. You WILL get through this, but it might take time to feel like yourself again, especially if you had multiple or higher degree tearing.

Fear of sex – At the regular 6-week postpartum appointment, your doctor will likely “clear” you for sex. However, this does NOT mean that you will feel ready to do so. Even if you feel ready and try it, your body could have other plans. Don’t rush, and make sure you communicate your needs to your partner. It could take months to get past the anxiety and heal from your tearing to get back in the saddle.

Fear of using the bathroom – The first poop after having your baby is a known fear. If you’ve suffered bad tearing, it might be months before you can poop without crying. Honestly, it’s horrible. Do your best to breathe through it, and please seek help earlier than I did. I went through it for 7 months and would cry before I even sat down because I knew the pain was coming! There IS help and hope for you, and you don’t have to live that way; it can be so depressing, but it doesn’t have to last forever.

Fear of having another baby – Before I had my son, I wanted a whole basketball team full of babies. After going through the grueling aftermath of having a single 10-pound baby, I questioned if I’d ever be able to do it again. I felt sad and scared, and I was wondering if I’d have to adjust my vision of my family. Again, I tell you, you will slowly recover. I’m in a place now where I know I could handle having more kiddos, and I wish I’d had someone to tell me that I really would feel better the further into the first year I got.

Frustration at your body’s healing timeline – If you’ve experienced a birth tear, it’s unrealistic to expect your body to feel normal within the 6 weeks that you probably expected it to. Society puts the pressure on us to get back into the gym, the office, the social scene. This might work for a small percentage of moms, but for the moms that are trying so hard to heal from severe tearing in private, this is extremely damaging. Even worse, you’re probably going to be told by medical professionals that you’re “cleared” to resume all activity. To be told you should be able to act normal but feel so far from it can make you feel ashamed of yourself and add your own pressure to the situation. Please resist the urge to buy into this! There is no timeline on healing your tearing, but one day you’ll realize you’re not in as much pain anymore.

To the moms that are healing from a birth tear, don’t be afraid to talk about it and advocate for yourself. If you have lasting physical effects, find the right specialist that can help you, and don’t accept anything less than the care you deserve. Birth tears and their complications are brushed off and minimized, even though they shouldn’t be. Finally, don’t compare yourself to other moms. You might have friends that had the easiest delivery and recovery ever. It’s natural to feel jealous and upset that your experience was so different. I even found myself wishing that I could’ve had a c-section. In reality, I had the birth experience I was meant to have, and I am doing great now! Being jealous of someone else’s easy breezy beautiful motherhood journey, I was robbing myself of my own happy moments and beating myself up for my small wins. Please know that your pain won’t last forever, even if it’s dragging on way longer than you’d hoped. It can feel lonely, but just remember the stats – SO many moms are probably feeling just as lonely as you are. Maybe if you open up about it, you can help yourself and others feel seen, heard and held.

#TruthMom