Yep it can happen. You can indeed tear “the wrong way”. I did not even know this was possible until I felt a slight pain and heard the doctor say, “Sorry but I have to stitch up near your clitoris.” MY WHAT!? How was that even possible! Although tearing sounds scary, here are some things I learned from my experience of tearing up top to help ease your mind.
1. It is usually uncommon
This is called a periurethral laceration. Tearing during childbirth is completely normal, especially for first time deliveries. Tearing up top near the urethra is not very common.
2. I didn’t feel a thing
Part of this was in part to my epidural I had very late in labor. It is possible to have an epidural at 10cm. Another part due to the fact that while you are pushing a baby out the only thing you are focused on is your baby and getting it out! After I did not notice either because I was feeling the greatest joys to have my son and such a relief to have him out! (I also received local anesthetic for the stitching I received after)
3. My recovery was easier than you would expect.
From what I have researched, there are no actual muscles tearing near the top. This actually makes me recovery slightly easier than someone with a perineal tear. It was not hard for me to sit like a deep perineal tear might be. Mainly it just burned when I peed and I just had to use the lovely squirt bottle they give you every time I peed for a little longer than most.
4. I could have greatly benefitted from a doula!
I decided to get my epidural during the pushing phase of labor (rather than sooner or not at all). Because of this I really was not as effective at pushing as would be most beneficial. I remember them to just tell me to push like I was before and I had no idea where or what they were talking about. It took some time to learn how to push (this is very common with first time deliveries as well) I believe I was pushing in the “wrong places.” It seemed to me like I was blindly pushing. I remember in that moment, as well as several others during my birth, wishing I had a doula there to help coach and cheer me on.
5. An episiotomy might have prevented this from happening
“Might have”. Usually with tears that are high near the urethra the baby is crowning and coming out so fast that there is no time for an episiotomy. However, in some cases, this is why episiotomies are a tool that doctors and midwives can use. Being open to an episiotomy if needed (or any other medical procedure you might not have originally wanted) can greatly benefit you. Another important piece is having an open communication with your birth team is a great way to do this.
My last thoughts on this? Yes, I did tear near my urethra and clitoris. Yes, I have made a full recovery and everything is working exactly as it did before I had my son. But for my next birth, I will probably be looking into perineal support more as well as being open to an episiotomy if needed.
Authored by Alexis Beach, labor and postpartum doula