Labial tear

Evidence  

https://www1.racgp.org.au/ajgp/2018/january-february/perineal-tears-a-review 

Ryan Goh   Daryl Goh   Hasthika Ellepola   

Anterior perineal trauma can affect the anterior vaginal wall, urethra, clitoris and labia.  

Education 

A labial tear is a tear of the skin or soft tissues that form the vulva. The labia are the folds of skin that can be seen on either side of the vaginal opening. The labia may suffer some form of trauma during childbirth, particularly if an episiotomy or assisted delivery is performed.  

While these types of tears occur commonly during vaginal birth, they are not talked about as often as other types of vaginal tears. Your health care providers may also refer to the injury as ‘grazing’ or a ‘first degree tear’. 

If a midwife or obstetrician notices there has been labial tearing, it may be stitched/sutured immediately after birth, or they may decide to allow it to heal naturally, depending on the severity and location of the tear. If there are labial tears on both sides, it is often best to repair them separately, so the edges don’t heal together, narrowing the vaginal entrance. 

If the tearing is not noticed soon after birth, this can lead to the area healing with some ongoing challenges. You may only realise you have a tear because you continue to feel a burning or stinging sensation when you pass urine. Ongoing problems such as friction and increased sensitivity are more likely in those who were not stitched after birth. Some may find that one side of their labia is longer than before and sometimes the skin can remain split where it once joined together. 

A labial tear can be very painful for the first few weeks after birth. Most women report pain when sitting or using the toilet. Ice packs and creams can help alleviate the pain and reduce swelling. Within a month, the labial tear should be fully healed, and the stitches should dissolve. 

Your mental health 

A labial tear can understandably impact wellbeing. For some, it can be upsetting to look at the area, and you may feel uncomfortable about having sex with your partner as you come to terms with the new appearance. It's important to seek medical support for the treatment of the condition and your mental health.  

If you are concerned about your symptoms or are finding it hard to manage, you should speak to your GP. In an emergency, you should call 000. 

You can also reach out to organisations such as PANDA. They have highly trained and caring counsellors and peer practitioners who can help you work through and support you in your birth trauma journey. 

Psychological or emotional birth trauma 

Birth Trauma Australia defines “birth-related trauma” as any injury or trauma, whether physical or psychological, sustained at any time in connection with all stages of the birth journey - from conception and pregnancy, through to labour and birth, and in postnatal care and can affect the mother, birthing parents, partners and even health professionals.   

This can present as postnatal depression, postpartum post-traumatic stress disorder, or Obsessive-compulsive disorder. 

Birth Trauma Australia offer free resources to new parents, including evidence-based information on birth trauma support and healing. 

Empowerment  

Sometimes, you may only become aware of labial tears later, when there is discomfort, you observe a difference in the appearance of the labia or where there are problems with healing. Sometimes, labial tears may heal as separate pieces or result in excess skin, which may sometimes cause pain and discomfort.  

Labial tears are common and usually heal well; any ongoing pain, discomfort, or deformity should not be dismissed as a normal consequence of childbirth. If your labial tear affects your quality of life, please do not feel embarrassed to ask questions, seek help or get a second opinion. 

If you have any worries or concerns about how the labial tear is healing, if the pain is not improving after a few weeks, or if you are unhappy with the new appearance, contact your Obstetrician/Gynaecologist or GP.  

Useful Links 

Special thanks to Birth Trauma Australia for content sharing and providing support for families.  

https://birthtrauma.org.au/physical-birth-trauma/labial-tears/ 

https://birthtrauma.org.au/physical-trauma/ 

https://birthtrauma.org.au/birthing-decisions-after-birth-trauma/ 

PANDA – Perinatal Anxiety & Depression Australia 

https://panda.org.au/ 

For When 

www.forwhen.org.au

COPE - Centre of Perinatal Excellence  

https://www.cope.org.au/preparing-for-birth/things-dont-go-plan/ 

Pregnancy Birth and Baby 

https://www.pregnancybirthbaby.org.au/birth-trauma-emotional 

Need support? NurtureConnect allows you to connect with our NurtureProgram support team, or call our 24 hour NurtureLine 1300 622 243 or join our Facebook community.

NurtureConnect