What is a Labial Tear?
A labial tear is a tear of the skin or soft tissues that form the vulva. This can include the labia minora or majora or the clitoral hood. While they occur commonly during vaginal birth they are not talked about as often as other types of vaginal tears. Your 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 deformity. 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.
You may feel pain or soreness around the tear for several weeks after giving birth, especially when walking, sitting or using the toilet.
After birth, midwives often recommend passing urine while leaning forward on the toilet (this is typical advice to reduce discomfort for the more common perineal tearing) however this position may cause the area to sting even more when there has been labial tearing. Instead it can be helpful to try urinating in the shower or pouring body temperature water over the area while leaning backwards on the toilet instead.
Keep the area clean by having a bath or a shower at least once a day and change your sanitary pads regularly. This will reduce the risk of infection. You may find resuable cloth pads/underwear more comfortable. You could ask your midwife, obstetrician or GP about trying postpartum ‘sitz’ baths where you sit in a bathtub for a few minutes in warm salty water up to your hips. Although not necessary, there are many products available which can be added to the bath water including Epsom salts or postpartum soaks.
An ice pack may be helpful if the area is bruised and/or swollen. Do not place these directly on the skin as this can cause further damage.
You should aim to drink at least 2-3 litres of water every day and you could speak to your midwife, obstetrician or GP about taking a urinary alkaliser to reduce the stinging. If stinging persists, make sure your care provider checks for a urinary tract infection.
It may also be helpful to be assessed by a pelvic health physiotherapist (also known as women’s health physiotherapist), your midwife, or doctor, to check the area and discuss general pelvic health including pelvic floor exercises. Your midwife or doctor can assess any scar tissue which may arise due to your injury and recommend appropriate options.
For some, it can be upsetting to look at the area and you may feel uncomfortable about resuming sex with your partner as you come to terms with the new appearance. If you are concerned, your care providers can offer a range of options for you to consider.
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. If you have any worries or concerns about the way the labial tear is healing, if the pain is not getting any better after a few weeks, or if you are unhappy with the new appearance,
contact your Obstetrician/Gynaecologist or GP. In some cases, surgery may be offered after a discussion of the benefits and risks.
In summary, while 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 is affecting your quality of life in any way, please do not feel embarrassed to ask questions, seek help or get a second opinion.