Grade 1–2 perineal rupture is a condition when there is a tear in the birth canal, namely the vagina and the area around it, after delivery. The tearing of skin and muscle tissue in the area can occur due to stretching or strong pressure in the birth canal when the mother pushes to deliver her baby.
Perineal rupture is a condition that is quite common in the normal delivery process. This condition is more at risk for mothers who have given birth for the first time, have given birth to a large fetus, have undergone a prolonged labor process, or require delivery assistance, such as forceps or vacuum.
To reduce the risk of a severe perineal tear, the doctor or midwife will usually perform an episiotomy. This action is also done to facilitate the delivery process.
Perineal Rupture Severity
Based on the depth or length of the tear, perineal rupture can be classified into 4 stages, namely:
Grade 1 perineal rupture
Grade 1 perineal rupture is the smallest and lightest type of tear. At this level, the part that is torn is the skin around the surface of the mouth, the vagina or the skin of the perineum. Grade 1 perineal ruptures usually do not require stitches and heal in about 1 week.
Although the tear is mild, this condition can cause slight pain or stinging when urinating, sitting, coughing, sneezing, or having sex.
Grade 2 perineal rupture
In grade 2 perineal rupture, the part torn is the skin and muscles of the perineum on the inside of the vagina. This condition needs to be treated with stitches and can take about a few weeks to heal.
Just like type 1 perineal rupture, this type of tear will also cause discomfort when carrying out certain activities.
Grade 3 perineal rupture
Grade 3 perineal rupture occurs when a tear occurs in the skin and muscles of the vagina, perineum, and anus. This condition needs to get medical attention because it can cause heavy bleeding.
Grade 4 perineal rupture
Grade 4 perineal rupture is the most severe grade of perineal rupture. This condition occurs when the tear has reached the anus and rectum or even the large intestine. This condition needs to be treated with surgery.
How to Relieve Pain Due to Perineal Rupture Grade 1–2
To relieve pain from grade 1–2 perineal rupture and speed up the healing process, you can take the following steps:
- Reduces pressure on the vagina and perineumTry resting or sleeping on your side and use a soft pillow or pad when sitting to reduce pressure on the vaginal and perineal area. While resting, you are also advised not to push a lot and lift heavy weights.
- Keep the injured area clean and dryDuring recovery, you need to keep the tear or stitches after normal delivery on the perineum clean and dry to prevent infection. Clean the vagina and perineum after urinating or defecating and pat dry.
- Give cold compressTo reduce pain and swelling in the injured perineum, you can give a cold compress with ice wrapped in a clean cloth on the perineum for 10-20 minutes. Cold compresses on the perineum can be repeated up to 3 times a day.
- Taking pain relieversIf some of the methods above don't work to reduce the pain due to grade 1–2 perineal rupture that you are experiencing, you can use pain relievers, such as paracetamol, according to the doctor's prescription and advice.
Grade 1–2 perineal rupture is quite common and usually resolves within a few weeks of normal delivery. However, to reduce the risk of mild or severe perineal rupture, you can do the following tips:
- Do Kegel exercises to strengthen the pelvic floor muscles and increase the flexibility of the birth canal.
- Perform perineal massage regularly during pregnancy and before delivery.
- Compress the perineum with a warm towel before delivery to increase blood flow and relax the muscles.
- Take care of your health during pregnancy by following a healthy diet and regular exercise and taking prenatal vitamins.
During childbirth, pregnant women are at risk of perineal rupture grades 1-2. However, this condition can usually be treated by a doctor or midwife.
If during the recovery period of your perineal rupture you feel certain symptoms, such as fever, lacerations or purulent stitches, or very severe pain, immediately consult a doctor to get the right treatment.