Practice sutures on an orange, image for vaginal tearing during birth

Updated April 17 2023

Vaginal tears are ONE of the most common, if not THE most common, injury associated with birth.⁠

And most of the generic advice we get after childbirth, is tuned for folks with a 1st degree or mild 2nd degree tear.⁠

For example:

  • Take 2 weeks rest.
  • Take it pretty easy the first 6 weeks.
  • Gradually incorporate more movement and activity as comfort allows.

But for some folks with a 2nd degree tear, and certainly for folks with a a 3rd or 4th degree tear, recovery is likely going to follow a different timeline.⁠

Consider what actually happened to your body:

2nd degree tears involve damage to your pelvic floor muscles and 3rd and 4th tears extend into your anal sphincter.⁠

It’s not a casual injury.

If you have a higher degree tear, here are a few things to know:

You will likely need more than 2 weeks rest immediately postpartum.

You’ll likely need to take it fairly easy for 6-8 weeks (or longer). While your tear is healing, avoid strenuous activities or exercises that will create a lot of strain or pressure into the perineum and anus.

During this early recovery period, you can begin learning to manage your intra-abdominal pressure using the Connection Breath.

Expect that it will take a little longer than the “standard” 6 week timeline to return to structured exercise.

You’re more likely to experience incontinence.

You’re more likely to experience uncomfortable and inconvenient pelvic floor symptoms (like leaking of urine or poop) in the near term.

Pelvic floor physical therapists can help reduce these symptoms with early interventions.

They can assess your scar, massage away scar tissue and help you restore full pelvic floor function. ⁠

Once perineal tears heal and surrounding tissues recover, most people will not have long-term symptoms from 3rd and 4th degree tears.

Take advantage of professional guidance.

Return to exercise will start with core and pelvic floor exercises.

But you might require special cueing to get your anal sphincter muscle working properly again- and for this, you’ll want professional assessment and support.⁠

If you have higher degree tear, pelvic floor physical therapy will be an essential component of a full recovery and return to exercise.

If your return to exercise takes more than the standard 6 weeks- I urge you to be patient with yourself.

Set your expectations according to YOUR birth outcome, not generic advice that doesn’t take your injuries into account.

I offer one-on-one postpartum personal training to support your unique circumstances and timeline. If you would like support as you return to exercise after a perineal tear, please contact me.

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Redmond, WA-based Seattle birth doula Laura Jawad, headshot

My mission is to make sure that having a baby is not a reason why you can’t do all the things.

I offer customized, online pregnancy and postpartum personal training to folks locally (Seattle-area, Bellevue, Redmond, Kirkland) and beyond.

Laura Jawad holds a PhD and a personal training certification (NASM). She’s a proud Certified Prenatal & Postnatal Coach and Pregnancy & Postpartum Athleticism Coach. You can check out the rest of her alphabet soup here.