Vaginal Tearing

Vaginal Tearing or Episiotomy During Delivery

If you had any tearing during a vaginal delivery, it’s important to discuss the extent of that tearing with your doctor or midwife before starting an exercise program or starting Kegel exercises (contracting your pelvic floor muscles).

Your doctor or midwife may not discuss this with you as standard discharge instructions unless you ask, so the question you should be asking is, “When can I start doing pelvic floor or Kegel exercises?”

This information is pretty technical, so please consult with your doctor or midwife about it – I’m just going to give you an overview for your awareness and as a precaution for starting pelvic floor contractions.

Vaginal tearing is classified into 4 degrees of laceration based upon the extent of the injury:

First degree:

Involves just the skin and tissue just beneath the skin, but no muscles.

Second degree:

Involves everything in a first degree injury plus some of the muscles of your pelvic floor, including your levator ani muscle group, but the anal sphincter muscles are not involved.

Third degree:

Involves everything in a second degree injury plus your anal sphincter muscles.

Fourth degree:

Involves everything in a third degree plus the rectal mucosa (the injury has gone all the way through to your rectum).

If you had an episiotomy, that is automatically at least a second degree laceration.

Any time the pelvic floor muscles are injured (2nd-4th degree lacerations) and need to be sutured, it’s important to rest those muscles long enough to heal. Even with a first degree laceration, you will likely need to take time before beginning Kegels to allow the sutures to hold. Only your obstetrician or midwife will be able to tell you how long that should take, based upon the number, type, and location of sutures that you needed.

Usually, although your situation may be different, so again, talk to your obstetrician, that means 1 week before you can start Kegels for 1st degree, 2 weeks for 3rd degree, and 3+ weeks for 3rd and 4th degree lacerations.

For this program, that means your initial core drill may just be a wide rib breath + a belly button pull with NO pelvic floor contraction for the first week or more, depending on your obstetrician’s answer.