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For my Steam Project of 2023 my objective is to explain the stages of labor/childbirth and go further into it. Labor has three stages which are the dilation stage, the expulsion stage, and the placental stage. During the dilation stage, the cervix dilates slowly until 10 centimeters which is when the baby can fit its head through to progress into the next stage. Then is the expulsion stage, which is where my project is mainly centered. This is where the uterus and the muscles are contracting during pushes to help the baby exit the uterus, vagina, and then out. Finally the last stage is the placental stage which is where the placenta detaches from inside the uterus. This is also called the afterbirth. During the afterbirth a birthing person has small, weak contractions to help push the placenta out.
During the expulsion stage, a birthing person can experience vaginal tears right when the baby’s head is exiting the vagina. There are 4 different kinds of tears and each can be painful and uncomfortable for a birthing person.
The first degree stage is where the vaginal perineal skin and the mucosa layer is torn. This causes mild pain as well as stinging but usually doesn’t require stitches and will heal on its own in a few weeks.
The second degree stage is where the perineal skin as well as the muscle tissue is torn and is the most common kind of tear. This muscle tissue is known as the transverse perineal muscle and this usually requires stitches. These kinds of stitches can be done by the birthing person’s doctor while they’re doing skin to skin with their baby. It doesn’t require anesthesia or an operating table. The stitches do absorb into the body so the doctor doesn’t have to worry about taking them out later when the birthing person is healed. This kind of tear usually heals in a few weeks as well.
The third degree stage is where the skin, muscle tissue, as well as the anal sphincter muscles are torn. The anal sphincter muscles are used to bear down in order to pass a stool. This kind of tear usually requires anesthesia in an operating room to repair and stitch. It takes several weeks for this kind of tear to heal. The doctors also use stitches that will absorb into the body so they don’t need to be taken out later.
The fourth degree stage is where the skin, muscle, anal sphincter muscles, as well as the rectal mucosa is torn. This is the least common, yet most severe kind of tear and is by far the worst. It requires stitches and repair in the operating room with anesthesia. This tear also takes several weeks to heal from.
Tears usually happen during a birthing persons’ first delivery, having a large baby, or even during face-up deliveries where the baby isn’t face down like a more “normal” kind of birth. If the birthing persons’ doctor uses forceps or even a vacuum during delivery to help assist the childbirth, it can also cause a vaginal tear during the process. There is a myth that an episiotomy, where the doctor makes an incision to help the baby’s head come out easier, will prevent tearing. This is actually one of the main causes for tearing because the tissues are already separated and can continue to tear farther down, usually ending up in a third to fourth degree tear.
Some things a birthing person needs to look out for during healing is to watch for any foul smells coming from the area, fevers, or any pain that just won’t go away even when taking medications. This could be a huge sign of an infection and they should get checked out with their provider as soon as possible.
Luckily, as painful as these tears are, there is a little bit of relief a birthing person could get. Using a peri bottle during urination or even after using the bathroom will help with healing and stinging. Also, they should never wipe and only pat dry. A birthing person can also take an over the counter medication to help with pain and can even ask their provider to prescribe numbing spray for these areas. They should/can also take a stool softener and drink lots of fluids to avoid constipation because constipation with a vaginal tear is extremely painful. They can also sit on a pillow or even take a warm bath with the water level up to their hips for five minutes at a time. Another good option is to use an ice pack and witch hazel pads on the area, but not directly on the area and should always be under an undergarment or another type of sanitary pad.
Overall, there are 4 different degrees of vaginal tearing during childbirth with each of them with their own tissues being torn. Tearing is painful but a birthing person doesn’t have to be in pain alone as there are great resources and medications available for healing and pain management.
References
Cakwira, H., Mukengere, M., Lucien, B., Aborode, A. T., Sironge, L., Michael, M. V., & Akilimali, A. (2022, August 18). The clinical characteristics of perineal tears: A study carried out on 14 pregnant women in a tertiary center: Case series. Annals of Medicine and Surgery. Retrieved April 20, 2023, from https://www.sciencedirect.com/science/article/pii/S204908012201192X
Childbirth . Helsenorge. (2020, July 16). Retrieved April 20, 2023, from https://www.helsenorge.no/en/childbirth/phases-of-childbirth/#:~:text=Labour%20is%20divided%20into%20three,to%20up%20to%2060%20minutes.
Mayo Foundation for Medical Education and Research. (2022, January 20). Vaginal tears in childbirth. Mayo Clinic. Retrieved April 20, 2023, from https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/multimedia/vaginal-tears/sls-20077129?s=1
Real Talk: Vaginal Tearing during Childbirth. Penn Medicine Lancaster General Health. (2022). Retrieved April 20, 2023, from https://www.lancastergeneralhealth.org/health-hub-home/motherhood/your-pregnancy/real-talk-vaginal-tearing-during-childbirth
Smith, L. A., Price, N., Simonite, V., & Burns, E. E. (2013, March 7). Incidence of and risk factors for perineal trauma: A prospective observational study. BMC pregnancy and childbirth. Retrieved April 20, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3599825/
Vaginal Tears During Childbirth. Cleveland Clinic. (2022). Retrieved April 20, 2023, from https://my.clevelandclinic.org/health/diseases/21212-vaginal-tears-during-childbirth
Abstract: Vaginal tearing (perineal lacerations) during childbirth
There are 3 stages of labor; The dilation stage, the expulsion stage, and the placental stage. The expulsion stage, in which the fetus is pushed through the birth canal and out by powerful contractions of the uterus, is where vaginal/perineal tearing can occur. These vaginal tears are classified into 4 different degrees of severity based primarily on how much damage to vaginal and surrounding tissues occurred. A 1st degree vaginal tear is the least severe with only minor damage done and no need for repairs, while a 4th degree tear is the most severe with significant damage done to maternal tissue requiring surgical repair. Grades 2 and 3 lie in the middle with varying degrees of tissue damage respectively. 1st and 2nd degree vaginal tears are relatively common, while the more severe 3rd and 4th degree tears usually occur as a result of complications during birth such as a large fetal head or the use of forceps to assist delivery. A woman who has suffered vaginal tears during childbirth should be closely monitored by her doctor for signs of infection and be given the tools needed to promote healing and to reduce pain.
*PLEASE DISREGARD 1st. COMMENT AS IT WAS INCOMPLETE*
Abstract: Vaginal tearing (perineal lacerations) during childbirth.
Kylee’s project categorized and explained degrees of vaginal (perineal) tearing during childbirth, which falls within Objective 11 of Unit 9: The Reproductive System. The depiction characterized each degree of vaginal tearing that can occur.
There are 3 stages of labor; The dilation stage, the expulsion stage, and the placental stage. The expulsion stage, in which the fetus is pushed through the birth canal and out by powerful contractions of the uterus, is where vaginal/perineal tearing can occur. These vaginal tears are classified into 4 different degrees of severity based primarily on how much damage to vaginal and surrounding tissues occurred. A 1st degree vaginal tear is the least severe with only minor damage done and no need for repairs, while a 4th degree tear is the most severe with significant damage done to maternal tissue requiring surgical repair. Grades 2 and 3 lie in the middle with varying degrees of tissue damage respectively. 1st and 2nd degree vaginal tears are relatively common, while the more severe 3rd and 4th degree tears usually occur as a result of complications during birth such as a large fetal head or the use of forceps to assist delivery. A woman who has suffered vaginal tears during childbirth should be closely monitored by her doctor for signs of infection and be given the tools needed to promote healing and to reduce pain.