Vaginal tears in pregnancy and how they can affect your pelvic floor

The pelvic floor is tried and tested during pregnancy and delivery.⁣ During pregnancy, your pelvic floor muscles will loosen in response to the pregnancy hormones in your body. Your growing baby will also add additional pressure onto your pelvic floor and bladder, and you may find you leak urine when you cough or sneeze.⁣
⁣⁣
During labour, as baby’s head descends into the pelvis, it continues to stretch and displace these muscles for delivery. It is for this reason we encourage pelvic floor exercises in the antenatal period and perineal massage.

At the time of pushing, the perineum is prone to injury. An episiotomy can be given to control the injury.  ⁣

What can be done to prevent this?

• Perineal massage from 35 weeks may help
• Hands-on the perineum at the time of delivery

How to encourage healing?

• Keep the wound clean and dry, take a shower not a bath, change pads regularly, use laxatives to reduce pressure on stitches

What to watch out for?

Wound infection is most common.  Signs and symptoms include discharge, pain, redness and wound breakdown. This will need to be treated with antibiotics for 7 days. 

In the postnatal period, we refer to physiotherapy for third and fourth degree tears to help strengthen the muscles and prevent long term harm.

However, there is still risk of long term harm with faecal incontinence, anal function, birth trauma and its effects on future deliveries.⁣

Pelvic floor exercises are very important after childbirth and may lead to speedier recovery. In fact, performing these exercises whilst pregnant and just before planning to get pregnant will lower your chances of experiencing symptoms after giving birth.⁣

A short guide to performing pelvic floor exercises:

• Make yourself comfortable 
• Tighten your pelvic floor – imagine you are desperate to pass urine and you are trying to stop yourself.
• Hold this for as long as you can for a maximum time of 10seconds
• Release and rest for 5 seconds
• Repeat this ‘tighten, hold and release’ aiming to do this 10 times
• Try to do some ‘faster squeezes’ too – you tighten as strong and quickly as possible then immediately release.
• You can do your exercises anywhere but not whilst you are passing urine!
• It may be easier to lie down to perform these exercises. 
• Eventually you can learn to perform these when sitting and standing up

How often do YOU do your pelvic floor exercises?