Recovery time from a vaginal delivery is usually shorter than the recovery time from a Cesarean section. But sometimes it can take a while, especially if you've experienced any lacerations or tears.

The perineum, or the region between the vagina and rectum, is vulnerable to tearing during delivery. Some studies show that women are more likely to tear during their first vaginal delivery, probably because this is the first time the area has been stretched to that degree. But whether it's your first or your tenth, delivery technique can make a huge difference. One study revealed that if normal, spontaneous vaginal deliveries are unrushed and occur in a controlled setting with a nurse, doctor, or midwife guiding the pushing process, there is a lower risk of obstetrical trauma. Many health experts recommend perineal massage in the weeks prior to delivery as a way to lower the chances of tearing. Unfortunately, some women experience tears despite their own best efforts and the efforts of their health care professional.

Tears and Lacerations

Tears and lacerations vary in severity and are classified accordingly:

* First-degree tears are surface tears that involve the skin of the perineum and the vaginal connective tissue, usually near the vaginal opening. No muscles are involved. Healing time for first-degree tears is rapid, and women usually experience little discomfort. Stitches may or may not be required.

* Second-degree tears are deeper tears that involve the skin, connective tissue, and underlying muscles. Second-degree tears almost always require stitches, and healing time can vary. Most often, the stitches will dissolve on their own. Some women report feeling fine in a matter of weeks, others complain of experiencing pain for longer periods of time.

* Third-degree tears are more severe and involve the skin, connective tissue, and the external anal sphincter muscle, the muscle that you can squeeze to stop yourself from going to the bathroom.

* Fourth-degree tears are the most severe and can involve a tear through both the internal and external anal sphincter muscles and lining of the bowel. These tears often result in the loss of anal sphincter control, as well as fecal urgency and/or incontinence.

While third- and fourth-degree perineal tears are not common, they can happen to anyone. There are a few risk factors which may increase the chances:

* Larger babies

* Occiput posterior deliveries (baby is sunny-side up, or delivered faceup, instead of facedown)

* Nulliparity (delivery of first babies)

* Extended second stage of labor, or if the pushing stage lasts longer than an hour

* Midline episiotomies -- unfortunately, some women end up tearing further than the controlled incision

* Forceps delivery

Third- and fourth-degree lacerations can be extremely painful and may interfere with all sorts of activities, including intercourse, for quite some time after delivery. Many women find going to the bathroom, especially having a bowel movement, a huge challenge. One woman with a third-degree tear told me that having bowel movements after her delivery was worse than the actual delivery itself.

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